Curative effect of trimetazidine in patients with coronary heart disease complicated by chronic heart failure

CAI Chang-xin; LI Er-qin; ZHANG Ting

doi:10.3969/j.issn.1674-4055.2016.05.19

Abstract：Objective To investigate the influence of trimetazidine on left ventricular remodeling, N-terminal pro-brain natriuretic peptide (NT-proBNP) and heart rate variability (HRV) in patients with coronary heart disease (CHD) complicated by chronic heart failure (CHF). Methods The patients with CHD complicated by CHF (n=80, male 48, female 32 and average age=65.9±6.6) were chosen from Mar. 2014 to Mar. 2015, and randomly divided into treatment group and control group (n=40). The control group was given routine therapy, and treatment group was additionally given trimetazidine (20 mg/time, 3 times a day) for 6 m. The indexes of heart function were detected before and after treatment, including left ventricular end-systolic diameter (LVESd), left ventricular end-diastolic inner diameter (LVEDd), left ventricular ejection fraction (LVEF) and 6-minute walk test (6MWT) and level of NT-proBNP. The indexes of HRV time domain analysis were also detected, including SDNN, SDANN, RMSSD and PNN50. Results After treatment, the indexes of LVESd, LVEDd, LVEF and 6MWT and level of NT-proBNP were improved in 2 groups (all P<0.01), which was more significant in treatment group (all P<0.01). After treatment, the indexes of HRV time domain analysis (SDNN, SDANN, RMSSD and PNN50) increased significantly in 2 groups, which was more significant in treatment group (all P<0.01). The incidence of drug adverse reactions had no statistical difference between 2 groups (P>0.05). Conclusion Trimetazidine can reverse left ventricular remodeling, reduce level of NT-proBNP, promote HRV and improve autonomic nerve function and heart function in patients with CHD complicated by CHF.