Effect of trimetazidine on fibrinolytic factor expression in elderly patients with coronary atherosclerotic heart disease complicated with chronic heart failure

Wang Maojun; Cheng Yaling

doi:10.3760/cma.j.issn.1673-4777.2017.11.005

Abstract：Objective To investigate the effect of trimetazidine on cardiac function,tissue plasminogen activator(tPA) and plasminogen activator inhibitor-1 (PAI-1) in patients with coronary atherosclerotic heart disease (CHD) complicated with chronic heart failure.Methods Totally 112 elderly CHD patients with chronic heart failure from January 2015 to December 2016 in Guang'an People's Hospital were randomly divided into control group and observation group,with 56 cases in each group.The control group had conventional treatment;the observation group had trimetazidine besides conventional treatment;both groups were treated for 6 months.Effective rate,cardiac function indexes,N-terminal pro-brain natriuretic peptide (NT-proBNP) and fibrinolytic factors were analyzed.Results The total effective rate in observation group was significantly higher than that in control group [92.9％ (52/56) vs 76.8％ (43/56)] (P ＜ 0.001).There were no significant differences of left ventricular end-systolic diameter (LVESD),left ventricular end-diastolic diameter (LVEDD),left ventricular ejection fraction (LVEF),NT-proBNP,PAI-1 and tPA between groups before treatment (P ＞ 0.05).After treatment,LVESD and LVEDD in observation group were significantly lower and LVEF was significantly higher than those in control group [(33.2 ±0.9)mm vs (37.1 ±1.1)mm,(51±5)mm vs (56 ±6)mm,(51.2±1.6)％ vs (43.2 ± 1.3)％] (P ＜0.05);serum levels of NT-proBNP and PAI-1 in observation group were significantly lower and tPA was significantly higher than those in control group[(532 ± 123)ng/L vs (934 ± 144) ng/L,(62 ±4)μg/L vs (71 ±5)μg/L,(17.4 ±3.1) μg/L vs (13.1 ±2.8)μg/L] (P＜0.05).Conclusion Trimetazidine treating elderly CHD patients with chronic heart failure can obviously decrease NT-proBNP,PAI-1 and increase tPA in serum,regulate fibrinolytic function,control myocardial remodeling and improve myocardial cell function.