Clinical Research in Cardiology

, Volume 102, Issue 12, pp 915–922 | Cite as

Effects of trimetazidine in patients with acute myocardial infarction: data from the Korean Acute Myocardial Infarction Registry

  • Jeong Su Kim
  • Chang Hoon Kim
  • Kook Jin Chun
  • June Hong Kim
  • Yong Hyun Park
  • Jun Kim
  • Jin Hee Choi
  • Sang Hyun Lee
  • Eun Jung Kim
  • Dae Gon Yu
  • Eun Young Ahn
  • Myung Ho Jeong
Original Paper
First Online:
Received:
Accepted:

Abstract

Background

Excess myocardial fatty acid oxidation can cause a range of deleterious myocardial effects. Trimetazidine (TMZ) is a clinically effective antianginal agent that selectively inhibits long-chain 3-ketoacyl CoA thiolase, reducing fatty acid oxidation and stimulating glucose oxidation. The role of TMZ in acute myocardial infarction (AMI), however, remains unclear. Our retrospective analysis explores the effect on clinical outcomes of adding TMZ to standard treatment in patients with AMI.

Methods

All 13,733 AMI patients registered in the Korean Acute Myocardial Infarction Registry from 2005 to 2008 were retrospectively enrolled. Patients were divided into two groups: those treated with TMZ during their in-hospital management period and those who were not. Primary endpoints were all-cause death combined in-hospital and 12-month death and major adverse cardiac events (MACE), which included all-cause death, recurrent myocardial infarction (MI), repeated percutaneous coronary intervention (PCI) for target lesion revascularization (TLR), and coronary artery bypass graft. Propensity-matched patients were analyzed using an adjusted Cox proportional hazards model.

Results

Baseline clinical and angiographic characteristics in the TMZ and no-TMZ groups were generally similar, with the exceptions of pre-PCI thrombolysis in myocardial infarction flow grade, stent type, and stent length. Over 12 months, the relative risk of all-cause death fell by 59 % (event rate 2.3 vs. 6.4 %; hazard ratio 0.41, 95 % CI 0.18–0.97, P = 0.042) and the relative risk of MACE fell by 76 % (event rate 2.3 vs. 9.5 %; hazard ratio 0.24, 95 % CI 0.10–0.56, P = 0.001) in the TMZ group compared with those in the no-TMZ group.

Conclusions

Trimetazidine appeared to improve clinical outcomes in AMI patients by significantly reducing all-cause mortality and MACE over 12 months.

Keywords

Trimetazidine Acute myocardial infarction KAMIR All-cause mortality Major adverse cardiac event 
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Notes

Acknowledgments

This work was supported by a grant of the National Research Foundation of Korea funded by the Korean Government (MEST), Republic of Korea (2010-0020261), and by a grant of the Korea Healthcare Technology R&D Project, Ministry for Health, Welfare & Family Affairs, Republic of Korea (A084869).

Conflict of interest

The authors have no other relevant affiliations or financial involvement with any organization or entity in conflict with the subject matter or materials discussed in the manuscript.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Jeong Su Kim
    • 1
  • Chang Hoon Kim
    • 2
  • Kook Jin Chun
    • 1
  • June Hong Kim
    • 1
  • Yong Hyun Park
    • 1
  • Jun Kim
    • 1
  • Jin Hee Choi
    • 1
  • Sang Hyun Lee
    • 1
  • Eun Jung Kim
    • 3
  • Dae Gon Yu
    • 3
  • Eun Young Ahn
    • 3
  • Myung Ho Jeong
    • 4
  1. 1.Division of Cardiology, Department of Internal Medicine and Research Institute for Convergence of Biomedical Science and TechnologyPusan National University Yangsan Hospital, Pusan National University School of MedicineYangsanKorea
  2. 2.Department of Preventive and Occupational MedicinePusan National University School of MedicineYangsanKorea
  3. 3.Department of Internal MedicinePusan Medical University Yangsan HospitalYangsanKorea
  4. 4.The Heart Center, Chonnam National University Research Institute of Medical SciencesChonnam National UniversityGwangjuKorea

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