Background: The patomechanism of developing ischemic heart disease (i.h.d.) is stenosis of coronary blood vessels with plaque placed on vascular endothelium built with monocytes/macrophages, foam cells, oxidized LDL, leukocytes, platelets and collagen. Atherosclerotic lesions are heavily infiltrated by cellular components associated with inflammation and influenced by other inflammatory factors. Trimetazidine, a clinically effective antianginal agent acts by optimizing cardiac energy metabolism through inhibition of free fatty acid oxidation.
Up to now there have been no study associating trimetazidine possible anti-inflammatory effect which could be a result of trimetazidine influence on granulocytes in-flow to ischemic region and atherosclerotic plaque and in consequence influence on granulocyte products such as cytokines and other inflammatory predictors.
Objective: The aim of the study was to determine if trimetazidine treatment in stable ischemic heart disease altered the concentration of certain inflammatory factors such as CRP (acute phase response protein) and Interleukin (IL)-6.
Patients and method: 26 patients (11 women, 15 men) age 4765 years with diagnosed stable ischemic heart disease were included into study. All of them fulfilled the inclusion criteria (stable i.h.d. with standard treatment, rest ECG without ischemic changes and with cardiac sufficiency belongs to I or II class of CCS- (Canadian Cardiovascular Society scale).
All patients have measured the concentration of Il-6 and CRP at the onset of trimetazidine treatment and 3 months after. Il-6 concentration has been measured by ELISA using R&D System kits and CRP concentration by immunoturbidometric method.
Results: 3-months trimetazidine treatment caused significant decrease of CRP concentration in serum of patients with stable i.h.d. (P<0.001) and significant increase of IL-6 concentration (P<0.05).
Conclusion: Decrease of CRP concentration in serum after 3 months of trimetazidine treatment could be due to trimetazidine hepatoprotective properties. An increase of Il-6 concentration after 3 months of treatment with trimetazidine is possibly a result of different mechanism of its action.