Role of Trimetazidine in Prevention of Coronary No Reflow in Patients with ST Segment Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.

Abstract

oronary no reflow remains a nightmare for doctors who perform PPCI for STEMI patients. Hence attempts to understand, prevent and treat coronary no reflow in patients with STEMI undergoing primary PCI. The efficacy of TMZ in chronic coronary syndrome has been well demonstrated but data regarding the clinical effect of TMZ in managing acute myocardial infarction (AMI), prevention of reperfusion injury and prevention of coronaries no reflow are limited and remains unclear. Aim of the Work: To evaluate the role of trimetazidine in prevention of coronary no-reflow in Patients with ST Segment Elevation myocardial infarction undergoing primary Percutaneous Coronary Intervention. Patients and Methods: A Prospective observational open label study was conducted on 200 STEMI patients who underwent Primary PCI to the culprit vessel with no other significant lesion in other coronaries. They were subdivided to 2 groups: Group I (control group): 100 patients who received standard guidelines directed medical treatment; Group II: 100 patients who were treated by 60 mg loading trimetazidine before PPCI then were treated with TMZ 35 mg BID for 1 month in addition to standard guidelines directed medical treatment.