Effect of Trimetazidine on Functional Capacity in Patient with Ischaemic Cardiomyopathy (TOFCAPI)

Objective: This study aimed to evaluate the efficacy of trimetazidine on exercise capacity via a six-minute walk test in patients with ischaemic cardiomyopathy and also evaluate the effect of trimetazidine on left ventricular function via echocardiography in the same population. Methods: This prospective observational study, conducted at the National Institute of Cardiovascular Diseases in Dhaka, Bangladesh, enrolled 200 patients with ischaemic cardiomyopathy and a depressed left ventricular ejection fraction (LVEF Results: In this study (n = 200) of ischaemic cardiomyopathy patients, the mean age was 58 years, with 76% of the patients being male. All study subjects received GDMT (Guideline-Directed Medical Therapy) for angina and heart failure. Those who received the modified released form of trimetazidine developed lesions during the 1st and 2nd follow-ups, during which the LVEF, LVIDd, and six-minute walk distance significantly improved (p Conclusion: The findings of the present study demonstrated that the addition of modified-release trimetazidine to GDMT can improve exercise capacity and left ventricular function in patients with ischaemic cardiomyopathy.

Effectiveness of Atorvastatin Combined with Trimetazidine in the Treatment of Coronary Heart Disease in the Elderly and Their Effect on Cardiac Function

Objective:To analyze the effect of atorvastatin combined with trimetazidine in the treatment of elderly coronary artery disease and the effect on patients’cardiac function.Methods:60 cases of elderly coronary artery disease patients were divided into 2 groups by randomization method,and all of them received conventional symptomatic treatment,while atorvastatin was added to the control group and trimetazidine was combined with atorvastatin in the observation group,and the clinical indexes were compared.Results:After treatment,the angina attack,cardiac function indexes,and inflammatory factor levels of the observation group were better than those of the control group(P<0.05),and the differences in adverse reactions between the two groups were not significant(P>0.05).Conclusion:Combined treatment of coronary heart disease in the elderly with atorvastatin and trimetazidine can positively reduce angina symptoms,improve cardiac function,and reduce inflammatory reactions,and the effect is definite.

正交设计优化TMZ-SLN处方组成与制备工艺

以替莫唑胺为模型药物,硬脂酸为载体材料,采用乳化-低温固化法制备替莫唑胺固体脂质纳米粒,正交试验设计优化处方组成和制备工艺,并对纳米粒的结构形态、粒径、表面电位、包封率、体外释药特性等进行了研究。结果表明,以优化处方制备的替莫唑胺固体脂质纳米粒为类球形实体,粒径分布比较均匀,平均粒径为65.0±6.2nm,ξ电位为-37.2mV,包封率为58.9%±1.21%,药物体外释放符合Higuchi方程,经差示扫描量热法(DSC)分析证明纳米粒确已形成。

硼替佐米通过下调FOXM1-Survivin轴抑制神经胶质瘤生长和对替莫唑胺(TMZ)敏感

背景与目的高级别神经胶质瘤(high-grade glioma,HGG)是一种致死性人类癌症。蛋白酶体抑制剂——硼替佐米已获批用于治疗多发性骨髓瘤,但该药物在神经胶质瘤中的应用仍需进一步研究。本研究探索了硼替佐米对神经胶质瘤的化疗效果及其潜在的作用机制。方法通过3-(4,5-二甲基-2-噻唑基)-2,5-二苯基-2H-溴代四唑[3-(4,5-dimethyl-2-thiazolyl)-2,5-diphenyl-2-H-tetrazolium bromide,MTT]实验、肿瘤细胞微球生长和克隆形成实验,检测了U251和U87细胞的活性和增殖。流式细胞计数检测了细胞凋亡和细胞周期。通过长期替莫唑胺(temozolomide,TMZ)给药诱导建立了TMZ耐药细胞系,在干细胞培养基中富集了具有干细胞特征的细胞。通过逆转录定量聚合酶链反应检测了目标基因的mRNA水平,并通过Western blot/免疫荧光染色及免疫组化染色分别检测了细胞系和石蜡包埋切片中的蛋白水平。通过裸鼠皮下接种U87细胞,建立了神经胶质瘤异种移植模型,以进行药物实验。使用Kaplan-Meier方法分析了患者的生存数据。结果通过诱导细胞凋亡和细胞周期阻滞,硼替佐米以剂量和时间依赖的方式抑制了U251和U87细胞的活性和增殖。硼替佐米还显著抑制了U251和U87细胞的微球生长、克隆形成和干细胞样细胞增殖。当联合使用时,硼替佐米与TMZ在体外表现出协同作用,在体内体外实验中均使神经胶质瘤对TMZ的敏感性增强。硼替佐米降低了叉头框M1(Forkhead Box M1,FOXM1)及其靶基因Survivin的mRNA和蛋白水平。在已建立的TMZ不敏感神经胶质瘤细胞系和HGG患者中,FOXM1-Survivin轴显著上调。FOXM1和Survivin的表达水平彼此正相关,且均与神经胶质瘤患者预后不良相关。结论硼替佐米可能通过下调FOXM1-Survivin轴抑制神经胶质瘤的生长并改善TMZ的化疗效果。硼替佐米单独使用或联合TMZ,有望成为治疗恶性神经胶质瘤的潜在药物。

X线辐射及TMZ化疗联合应用对脑胶质瘤表达干细胞标志物的影响

目的：探讨胶质瘤细胞接受联合X线辐射及T M Z化疗干预后其干细胞标志物的变化情况。方法将51例人脑胶质瘤标本作为观察对象，将标本分为22例脑胶质瘤Ⅰ～Ⅱ级的低级别组及29例脑胶质瘤Ⅲ～Ⅳ级的高级别组，所有入选标本均给予联合X线辐射及 TMZ 化疗干预。对比分析2组干预前后胶质细胞中CD133及 ABCG2的表达情况，并对CD133及ABCG2改善情况与细胞恶性程度的相关性进行分析。结果2组间CD133及ABCG2的表达均存在显著差异，高级别组表达程度均明显高于低级别组（P＜0.05）。2组在接受联合X线辐射及TMZ化疗干预后，CD133及ABCG2均明显改善，以低级别组改善更为明显（ P＜0.05），且治疗前后CD133及ABCG2改善度与细胞恶性程度存在负向直线相关性（ P＜0.05）。结论不同恶性程度的胶质瘤细胞中CD133及ABCG2的表达存在显著差异。联合X线辐射及TMZ化疗可有效改善CD133及ABCG2表达，且与细胞恶性程度存在负向直线相关性。

Protective Effects of Trimetazidine on Bone Marrow Mesenchymal Stem Cells Viability in an ex vivo Model of Hypoxia and in vivo Model of Locally Myocardial Ischemia

Bone marrow mesenchymal stem cells (MSCs) have shown potential for cardiac repair following myocardial injury,but this approach is limited by their poor viability after transplantation.The present study was to investigate whether trimetazidine (TMZ) could improve survival of MSCs in an ex vitro model of hypoxia,as well as survival,differentiation,and subsequent activities of transplanted MSCs in rat hearts with acute myocardial infarction (AMI).MSCs at passage 3 were examined for their viability and apoptosis under a transmission electron microscope,and by using flow cytometry following culture in serumfree medium and exposure to hypoxia (5% CO2,95% N2) for 12 h with or without TMZ.Thirty Wistar rats were divided into 3 groups (n=10 each group),including groupⅠ(AMI control),groupⅡ (MSCs transplantation alone),and group Ⅲ (TMZ+MSCs).Rat MSCs (4×107) were injected into peri-infarct myocardium (MSCs group and TMZ+MSCs group) 30 min after coronary artery ligation.The rats in TMZ+MSCs group were additionally fed on TMZ (2.08 mg?kg-1?day-1) from day 3 before AMI to day 28 after AMI.Cardiac structure and function were assessed by echocardiography at 28th day after transplantation.Blood samples were collected before the start of TMZ therapy (baseline),and 24 and 48 h after AMI,and inflammatory cytokines (CRP,TNF-α) were measured.Then the sur-vival and differentiation of transplanted cells in vivo were detected by immunofluorescent staining.The cellular apoptosis in the peri-infarct region was detected by using TUNEL assay.Furthermore,apoptosis-related proteins (Bcl-2,Bax) within the post-infarcted myocardium were detected by using Western blotting.In hypoxic culture,the TMZ-treated MSCs displayed a two-fold decrease in apoptosis under serumfree medium and hypoxia environment.In vivo,cardiac infarct size was significantly reduced,and cardiac function significantly improved in MSCs and TMZ+MSCs groups as compared with those in the AMI control group.Combined treatment of TMZ with MSCs implantation demonstrated further decreased MSCs apoptosis,further increased MSCs viability,further decreased infarct size,and further improved cardiac function as compared with MSCs alone.The baseline levels of inflammatory cyto-kines (CRP,TNF-α) had no significant difference among the groups.In contrast,all parameters at 24 h were lower in TMZ+MSCs group than those in MSCs group.Furthermore,Western blotting indicated that the expression of antiapoptotic protein Bcl-2 was upregulated,while the proapoptotic protein Bax was down-regulated in the TMZ+MSCs group,compared with that in the MSCs group.It is suggested that implantation of MSCs combined with TMZ treatment is superior to MSCs monotherapy for MSCs viability and cardiac function recovery.

Treatment of unstable angina with trimetazidine

Objective To evaluate the clinical therapeutic effects oftrimetazidine on the treatment of unstable angina （UA） as well as its effects on endothelin- 1 level and complications of patients. Methods One hundred and twenty patients with UA were randomized into the trimetazidine group （n =60） and the control group （n =60）, the trimetazidine group was subjected to treatment with 60 mg trimetazidine everyday for six months plus conventional treatment, and the clinical symptoms, changes in electrocardiogram, changes in the number of plasma circulating endothelial cells （CEC） and endothelin- 1 level of the two groups were observed after treatment for four weeks; and the incidence rates of cardiac arrhythmias, cardiac failure, hospitalization due to angina, myocardial infarction and sudden death were also observed after treatment for six months. Results 1） The total effective rate of integrative clinical therapeutic effects in the trimetazidine group and the control group after treatment for four weeks were 86.7% and 68.3%,respectively （P〈0.05）, and the excellence rates were 36.7% and 15% （P〈0.01）respectively; the total effective rates for the therapeutic effects in electrocardiogram were 66.7% and 46.7%,respectively （P〈0.05）, and the excellence rates were 30.0% and 11.7%, respectively （P〈0.01）. 2） The number of plasma CEC and endothelin-1 level of the two groups after treatment for four weeks significantly decreased （P〈0.05）, but the decreases in the trimetazidine group were even significant （P〈0.01 ）. 3） The incidence rates for cardiac arrhythmia in the trimetazidine group and the control group after treatment for six months were 10% and 20% （P〈0.05）, respectively, and the incidence rates for cardiac failure were 8.3% and 18.3%, respectively （P〈0.05）, and the incidence rates for hospitalization due to angina were 10% and 15%, and the incident rates for myocardial infarction were 3.3% and 13.3% respectively （P〈0.05）. Conclusion Trimetazidine can significantly improve the symptoms of UA and myocardial ischemia, reduce the damages to blood vessel endothelium and complications, and improve the prognosis.

MGMT-04多肽在人脑胶质瘤原代细胞中模拟抗TMZ耐药作用的实验研究

目的研究多肽MGMT-04模拟O 6-甲基鸟嘌呤-DNA甲基转移酶(MGMT)在人脑胶质瘤原代细胞系SHG-140中抗替莫唑胺(TMZ)耐药的实验。方法首先设计穿膜肽MGMT-04,并加以FITC示踪,再通过免疫荧光定位MGMT-04多肽可以到达细胞核发挥作用。通过流式细胞术检测各处理组SHG-140细胞凋亡的比例,包括正常对照组,MGMT-04多肽组,TMZ组,TMZ+MGMT-04多肽组。通过免疫荧光技术检测上述四组SHG-140细胞BCL2及C-PARP的表达。使用Western Blot法检测上述四组SHG-140细胞中凋亡相关蛋白PARP、Cleaved-PARP、BCL2、Caspase-3、Cleaved-Caspase-3、BAX、BCL2的表达。结果流式细胞术检测结果示正常对照组与MGMT-04多肽组的凋亡无明显差异,TMZ组凋亡细胞比例明显增加,而TMZ+MGMT-04多肽组较TMZ组的凋亡细胞比例下降。免疫荧光染色结果示TMZ+MGMT-04多肽组较TMZ单组BCL2表达高、Cleaved-PARP表达量降低。Western Blot结果进一步验证与正常对照组相比,经MGMT-04多肽单独处理的相关凋亡蛋白的表达无明显差异,而TMZ组较正常对照组的Cleaved-PARP、Cleaved-Caspase-3、BAX表达量增加,BCL2的表达量下降,两组之间的差异有统计学意义(P<0.05),而TMZ+MGMT-04多肽组较TMZ组Cleaved-PARP、Cleaved-Caspase-3、BAX表达量降低,BCL2表达量升高,两组之间的差异有统计学意义(P<0.05)。结论多肽MGMT-04在人脑胶质瘤原代细胞中具有抗TMZ而增强耐药作用。

Effect of Trimetazidine on Diabetic Patients with Coronary Heart Diseases: A Meta-Analysis of Randomized, Controlled Trials

Objective To explore the therapeutic effects of trimetazidine(TMZ)on diabetic patients with coronary heart diseases.Methods We conducted a comprehensive electronic search of PubMed,EMBASE,and Cochrane databases between the inception dates of databases and May 2019(last search conducted on 30 May 2019)to identify randomized controlled trials.The evaluation method recommended by Cochrane Collaboration for bias risk assessment was employed for quality assessment.Random or fixed models were used to investigate pooled mean differences in left ventricular function,serum glucose metabolism,serum lipid profile,myocardial ischemia episodes and exercise tolerance with effect size indicated by the 95%confidence interval(CI).Results Additional TMZ treatment contributed to considerable improvement of left ventricular ejection fraction(WMD=4.39,95%CI:3.83,4.95,P<0.00001),left ventricular end diastolic diameter(WMD=-3.17,95%CI:-4.90,-1.44,P=0.0003)and left ventricular end systolic diameter(WMD=-4.69,95%CI:-8.66,-0.72,P=0.02).TMZ administration also significantly decreased fasting blood glucose(SMD=-0.43,95%CI:-0.70,-0.17,P=0.001),glycosylated hemoglobin level(WMD=-0.59,95%CI:-0.95,-0.24,P=0.001),serum level of total cholesterol(WMD=-20.36,95%CI:-39.80,-0.92,P=0.04),low-density lipoprotein cholesterol(WMD=-20.12,95%CI:-32.95,-7.30,P=0.002)and incidence of myocardial ischemia episodes(SMD=-0.84,95%CI:-1.50,-0.18,P=0.01).However,there were no significant differences in serum triglyceride level,high-density lipoprotein cholesterol,exercise tolerance between the TMZ group and the control group.Conclusion TMZ treatment in diabetic patients with coronary heart disease is effective to improve cardiac function,serum glucose and lipid metabolism and clinical symptoms.

Role of Trimetazidine in Coronary Artery Bypass Graft Surgery

Trimetazidine is a drug that has been used to reduce the damage of reperfusion injury, which is a mechanism of oxidative aggression that occurs in coronary syndromes, angioplasty procedures, as well as in cardiovascular surgeries. Seeking to improve myocardial protection during procedures that involve reperfusion, attention was recently turned to research on cytoprotective drugs which act on segments of cellular metabolism, used in isolation or combined to reduce or prevent damage to the cardiac cell. The aim of this review is to objectively evaluate the effects of the drug trimetazidine (TMZ) on ischemia-reperfusion injury in coronary artery bypass graft surgery by reviewing all known studies from recent years.

Effect of Qishen Yiqi dripping pills combined with trimetazidine on the treatment of chronic heart failure: A meta-analysis

Objective:To systematically evaluate the safety and effectiveness of Qishen Yiqi dripping pills combined with trimetazidine in the treatment of chronic heart failure.Methods:A total of four English and Chinese electronic databases were searched:CNKI,VIP,CBM,PUBMED.Cochrane bias risk tools were used to assess the methodological quality of qualified studies.Meta-analysis was conducted by Review Manager 5.3.A total of 9 articles were included,with a total sample size of 855 cases,443 cases in the observation group and 412 cases in the treatment group.Results:Qishen Yiqi dripping pills combined with trimetazidine in the treatment of chronic heart failure has a total effective rate(RR=1.22,95%CI[1.15-1.30];p<0.00001),LVEF(MD=6.03,95%CI[5.39,6.67],P<0.00001),BNP(MD=-101.87,95%CI[-109.90,-93.83],P<0.00001),E/A(MD=-4.32,95%CI[-5.70,-2.93],P<0.00001),SYP(MD=-10.32,95%CI[-13.32,-7.32],P<0.00001),LVESD(MD=-5.50,95%CI[-6.03,-4.96],P<0.00001),6-MWT(MD=110.13,95%CI[96.89,123.36],P<0.00001)Adverse reactions occurred less frequently and did not affect treatment.Conclusion:This study shows that QYDP combined with TMZ can improve various indicators of CHF patients.However,due to the small sample size and the generally low quality of research,a more rigorous and reasonably designed RCT is needed to confirm these findings.

Effect of bisoprolol in combined with trimetazidine on the cardiac function rehabilitation in patients with chronic heart failure

Objective:To explore the effect of bisoprolol in combined with trimetazidine on the cardiac function rehabilitation in patients with chronic heart failure (CHF).Methods: A total of 84 patients with CHF who were admitted in our hospital from November, 2015 to October, 2016 were included in the study and randomized into the observation group and the control group. The patients in the two groups were given oxygen inhalation, lipid regulation, diuresis, ARB, and other routine treatments. Digitalis preparations were given for those who had poor cardiac function, and bisoprolol were orally administrated in the same time. On the above basis, the patients in the observation group were given trimetazidine dihydrochloride tablets, continuously for 3 months. The morning fasting peripheral venous blood before and after treatment in the two groups was collected. CRP, IL-6, TNF-α, BNP, NE, AngⅡ, ANP, ALD, and ET were detected. The cardiac color Doppler ultrasound diagnostic apparatus was used to detect LVPWT, PWS, PWD, IVSS, and IVMI.Results: CRP, IL-6, TNF-α, and BNP levels after treatment in the observation group were significantly lower than those in the control group. NE, AngⅡ, ANP, ALD, and ET levels after treatment in the observation group were significantly lower than those in the control group. LVPWT, PWS, PWD, IVSS, and IVMI levels after treatment in the observation group were significantly lower than those in the control group.Conclusions: Bisoprolol in combined with trimetazidine can significantly reduce the inflammatory reaction in patients with CHF, and effectively regulate the neuroendocrine stability in order to reverse or reduce VR and improve the left ventricular function.

Effect of Trimetazidine Dihydrochloride Tablets adjuvant therapy on inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function in patients with coronary heart disease complicated with heart failure

Objective: To investigate the effects of Trimetazidine Dihydrochloride Tablets on inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function in patients with coronary heart disease complicated with heart failure. Methods: A total of 98 patients with coronary heart disease and heart failure who met the criteria of the study were selected as the subjects, based on the random data table they were divided into the control group (n=49) and observation group (n=49), the patients in the control group were treated with Metoprolol Tartrate Sustained-release Tablets treatment, and the patients in the observation group were treated with Metoprolol Tartrate Sustained-release Tablets combined with Trimetazidine Dihydrochloride Tablets, the levels of inflammatory reaction, oxidative stress, vascular endothelial function and myocardial function indexes were compared between the two groups before and after treatment. Results: The difference of the CRP, TNF-α, MDA, SOD, NO, ET-1, LVEF, LVEDD and LVESD levels in the two groups before treatment were not statistically significant;Compared with the levels of the two groups before treatment, the two groups of CRP, TNF-α, MDA, ET-1, LVEDD and LVESD levels after treatment were significantly decreased, and the level of the observation group after treatment was significantly lower than those levels in the control group, the difference was statistically significant;The levels of SOD, NO and LVEF of the two groups after treatment were significantly higher than those in the same group before treatment, and the observation group levels [(88.09±7.51) U/ml, (72.58±14.64) mol/L, (48.34±5.09)% ] were significantly higher than the control group [(79.44±7.27) U/ml, (61.89±11.06) mol/L, (44.19±4.58)%], the difference was statistically significant. Conclusion: Trimetazidine Dihydrochloride Tablets in the treatment of coronary heart disease with heart failure can effectively inhibit the release of inflammatory factors, improve oxidative stress state, vascular endothelial function and myocardial function, has an important clinical value.

Effect of trimetazidine combined with bisoprolol on the cardiac function, ventricular remodeling and neuroendocrine factors in patients with chronic heart failure

Objective:To study the effect of trimetazidine combined with bisoprolol on the cardiac function, ventricular remodeling and neuroendocrine factors in patients with chronic heart failure.Methods: A total of 52 patients with chronic heart failure who were treated in our hospital between January 2012 and November 2015 were collected and divided into the control group (n=26) who received bisoprolol therapy and the observation group (n=26) who received trimetazidine combined with bisoprolol therapy according to the double-blind randomized control method, and both groups were treated for 3 months. Before treatment and after 3 months of treatment, cardiac color Doppler diasonograph was used to determine the levels of cardiac function parameters and ventricular remodeling parameters, and RIA method was used to determine the levels if peripheral blood neuroendocrine factors.Results: Before treatment, the differences in cardiac function, ventricular remodeling and neuroendocrine factor levels were not statistically significant between two groups of patients. After 3 months of treatment, cardiac function parameters LVEDd and LVESD levels of observation group were lower than those of control group while LVEF level was higher than that of control group, and ventricular remodeling parameters LVPWT, IVSS, PWD, PWS and LVMI levels were lower than those of control group;peripheral blood neuroendocrine factors NE, ALD, AngⅡ, ANP and ET contents of observation group were lower than those of control group.Conclusion:Trimetazidine combined with bisoprolol can optimize the cardiac function, suppress the ventricular remodeling process and regulate the neuroendocrine factor secretion in patients with chronic heart failure, and it contributes to the patients' overall optimization.

Identification of the E2F1-RAD51AP1 axis as a key factor in MGMT-methylated GBM TMZ resistance

Objective:Epidermal growth factor receptor variant III(EGFRvIII)is a constitutively-activated mutation of EGFR that contributes to the malignant progression of glioblastoma multiforme(GBM).Temozolomide(TMZ)is a standard chemotherapeutic for GBM,but TMZ treatment benefits are compromised by chemoresistance.This study aimed to elucidate the crucial mechanisms leading to EGFRvIII and TMZ resistance.Methods:CRISPR-Cas13a single-cell RNA-seq was performed to thoroughly mine EGFRvIII function in GBM.Western blot,realtime PCR,flow cytometry,and immunofluorescence were used to determine the chemoresistance role of E2F1 and RAD51-associated protein 1(RAD51AP1).Results:Bioinformatic analysis identified E2F1 as the key transcription factor in EGFRvIII-positive living cells.Bulk RNA-seq analysis revealed that E2F1 is a crucial transcription factor under TMZ treatment.Western blot suggested enhanced expression of E2F1 in EGFRvIII-positive and TMZ-treated glioma cells.Knockdown of E2F1 increased sensitivity to TMZ.Venn diagram profiling showed that RAD51AP1 is positively correlated with E2F1,mediates TMZ resistance,and has a potential E2F1 binding site on the promoter.Knockdown of RAD51AP1 enhanced the sensitivity of TMZ;however,overexpression of RAD51AP1 was not sufficient to cause chemotherapy resistance in glioma cells.Furthermore,RAD51AP1 did not impact TMZ sensitivity in GBM cells with high O6-methylguanine-DNA methyltransferase(MGMT)expression.The level of RAD51AP1 expression correlated with the survival rate in MGMT-methylated,but not MGMT-unmethylated TMZ-treated GBM patients.Conclusions:Our results suggest that E2F1 is a key transcription factor in EGFRvIII-positive glioma cells and quickly responds to TMZ treatment.RAD51AP1 was shown to be upregulated by E2F1 for DNA double strand break repair.Targeting RAD51AP1 could facilitate achieving an ideal therapeutic effect in MGMT-methylated GBM cells.

Meta-analysis of statin combined with trimetazidine on the regulation of inflammatory factors in coronary atherosclerotic heart disease and improvement of ventricular remodeling

Objective:To systematically evaluate the effects of statins combined with trimetazidine on the regulation of inflammatory factors and the improvement of ventricular remodeling in coronary atherosclerotic heart disease based on the inflammasomes/immune damage response theory.Methods:Using computer to search for EMbase,The Cochrane Library,Web of Science,MEDLINE,PubMed,WanFang Data,CNKI,China Biomedical Document Service System(CBM),VIP database(VIP),9 databases in total.The search time limit is from the inception of the databases to June 7,2021.All reference documents included in the study were manually searched.According to the Cochrane systematic review method,the information on atorvastatin combined with trimetazidine and conventional treatment(antiplatelet,control blood pressure,diuresis,coronary artery dilation and other expectant treatments)contrast the use of trimetazidine or stains combined with expectant treatment of coronary atherosclerotic heart disease patients in Chinese and English randomized controlled trials(RCT),and conduct the extraction and quality evaluation of the included literature data,using RevMan5.4 software for Meta analysis.Outcome indicators include inflammatory factors:C-reactive protein(CRP),IL-6(interleukin 6),tumor necrosis factor(TNF-α),and ventricular remodeling related outcome indicators:left ventricular end diastolic diameter(LVEDD),left Ventricular end systolic diameter(LVESD).Results:12 randomized controlled trials were included,a total of 1120 patients with coronary heart disease.Meta-analysis results:(1)inflammatory factors:the statin combined with trimetazidine group can significantly reduce the CRP,IL-6,TNF-α’s expression degree in the blood of patients with coronary heart disease compared with the control group(only statins or trimetazidine).CRP[n=770,SMD=-2.70,95%CI(-2.55,-1.40),P<-0.00001],TNF-α[n=678,SMD=-2.25,95%CI(-3.39,-1.12),P<-0.0001],IL-6[n=770,SMD=-2.10,95%CI(-3.10,-1.10),P<0.00001].(2)Ventricular remodeling:Compared with the control group(using statins or trimetazidine alone),the statin combined with trimetazidine group can significantly reduce the left ventricular end-systolic diameter of patients with coronary heart disease before treatment[n=626,SMD=-1.55,95%CI(-2.10,-0.99),P<-0.00001]and leftVentricular end diastolic diameter[n=626,SMD=-1.18,95%CI(-1.56,-0.80),P<-0.00001].Conclusion:Compared with the control group,statins combined with trimetazidine can significantly reduce the level of inflammatory factors based on the inflammasomes/immune injury response theory,and improve the ventricular remodeling in patients with coronary heart disease.

Effect of trimetazidine in combined with Huangqi injection in resisting inflammation and oxygen radicals in patients with acute viral myocarditis

Objective: To explore the effect of trimetazidine in combined with Huangqi injection in resisting inflammation and oxygen radicals in patients with acute viral myocarditis (AVMC). Methods: A total of 70 patients with AVMC who were admitted in our hosptial from October, 2015 to September, 2017 were included in the study and randomized into the observation group and the control group with 35 cases in each group. The patients in the control group were orally administrated with trimetazidine. On the above basis, the patients in the observation group were given intravenous injection of Huangqi injection. The patients in the two groups were treated for 4 weeks. The morning fasting peripheral venous blood before and after treatment was collected. The serum TFN-α, IL-6, CRP, MDA, SOD, NO, cTnI, CK, CK-MB, and LDH. Results: CRP, TFN-α, and IL-6 after treatment in the observation group were significantly lower than those in the control group. MDA and NO after treatment in the observation group were significantly lower than those in the control group, while SOD was significantly higher than that in the control group. cTnI, CK, CK-MB, and LDH after treatment in the observation group were significantly lower than those in the control group. Conclusions:Trimetazidine in combined with Huangqi injection in the treatment of AVMC can effectively play the anti-inflammation and anti-OFR effects in order to reduce the myocardial damage, thus, the therapeutic effect is enhanced.

Effects of preoperative trimetazidine application on myocardial injury indexes and oxidative stress indexes in patients with AMI after PCI

Objective:To investigate the effects of preoperative trimetazidine application on myocardial injury indexes and oxidative stress indexes in patients with AMI after PCI.Methods:A total of 70 patients with AMI who received emergency PCI in this hospital between January 2015 and January 2018 were divided into the control group (n=35) (received no trimetazidine) and the trimetazidine group (n=35) (received trimetazidine) according to the application of trimetazidine before PCI or not. The differences in the contents of myocardial injury markers, inflammatory factors and oxidative stress indexes were compared between the two groups immediately after admission and after surgery.Results: Immediately after admission, the differences in serum levels of myocardial injury markers, inflammatory factors and oxidative stress indexes were not statistically significant between the two groups of patients. Twenty-four hours after surgery, serum myocardial injury markers CK-MB, cTnⅠ, Myo and h-FABP levels of trimetazidine group were lower than those of control group;inflammatory factors hs-CRP, Neopterin and IL-1β levels were lower than those of control group;oxidative stress index SOD level was higher than that of control group whereas MDA and LHP levels were was lower than those of control group.Conclusion: Trimetazidine treatment before PCI can effectively optimize the postoperative cardiac function and reduce the oxidative stress response in patients with AMI.

Clinical Efficacy of Metoprolol Succinic Acid Sustained Release Tablets Combined with Trimetazidine in the Treatment of Gastrointestinal Tumors with Angina Pectoris

Objective:To investigate the clinical efficacy of metoprolol succinate sustained-release tablets combined with trimetazidine in the treatment of gastrointestinal tumors with angina pectoris.Methods:We enrolled the 58 patients with digestive tract tumor merger angina in November 2017-October 2019 and analysis the hospital clinical data by retrospective method.We included patients with routine treatment in control group(n=31 cases)and the subjects treated with increased dose of succinic acid metoprololzyban joint with trimetazidineinobservation group(n=27 cases)according to the different treatment group.Results:The effective rate of angina pectoris treatment in the observation group was higher than that in the control group.Furthermore,the incidence of adverse reactions was lower than that in the control group and the difference was statistically significant(P<0.05).Conclusion:Metoprolol succinic acid sustained release tablets combined with trimetazidine in the treatment of gastrointestinal tumors with angina pectoris can improve the efficacy of angina pectoris.The drug use is safe and worthy of clinical use.