ABSTRACT
Background: Surgical revascularization is the gold standard in the management of patients with multi-vessel coronary artery disease (CAD). It is well known that increased oxidative stress during ischemia-reperfusion and post-revascularization procedures leads to the release of free radical in the circulation. This process can cause reversible or irreversible myocardial damage. Aim: The aim of this study was to assess the effect of trimetazidine on decreasing postoperative ischemia-reperfusion myocardial damage. Material and methods: This prospective single-blind randomized controlled trial included 90 patients with elective surgery, operated between March 2018 and October 2018. The patients were divided into two equal groups, a study group and a control group; those in the study group received trimetazidine 35 mg b.d., immediately after tracheal extubation, in addition to their regular therapy. Pre- and postoperative levels of specific blood biomarkers such as high-sensitivity troponin T (hs-TnT), creatine kinase-MB (CK-MB), and malondialdehyde (MDA) were evaluated. Patients were followed for a period of 6 months after surgery. Results: MDA levels were lower in patients who received trimetazidine, leading to a reduction in oxidative stress and improved cardiomyocyte protection by augmentation of the antioxidant status. The quality-of-life assessment with the Minnesota Living with Heart Failure Questionnaire yielded excellent results. Conclusions: Improvement of myocardial cell metabolism and decreasing the level of postoperative ischemiareperfusion damage is alleviated by postoperative regular trimetazidine therapy.