November 19, 2011
[Abstract] Objective To evaluate the trimetazidine combined conventional therapy for unstable angina pectoris (UAG) of clinical efficacy. Methods 59 cases of patients with UAP were randomly divided into treatment group (n = 30) and the control group (n = 29), control group with conventional treatment given anti-platelet anti-clotting drugs, β-blockers, nitrates, calcium ion blockers, angiotensin-converting enzyme inhibitors and lipid-lowering drug therapy; treatment group were based on the I TMZ (20mg, 3 times a day) treatment, 8 weeks after application of Holter in the treatment before and after myocardial The total ischemic load (TIB) and clinical ischemia-related events recorded. Results After treatment, TIB treatment group was significantly less than the control group (P <0.05), compared with the control group, treatment group, the incidence of ischemia-related events decreased significantly (χ2 = 4.73, P <0.05). Conclusion Trimetazidine treatment of patients with UAP has a good anti-myocardial ischemia, and significantly reduced the incidence of ischemia-related events.
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Keywords trimetazidine; unstable angina; myocardial ischemia
unstable angina (unstable angina pectoris, UAP) is between stable angina and acute myocardial infarction between an acute myocardial ischemia due to the clinical syndrome. The high risk of cardiac events is the object, about 10% of the UAP into AMI. Therefore, choosing the appropriate treatment to improve the prognosis has important clinical significance [1]. The author in the conventional treatment based on the application UAP trimetazidine treatment of 30 patients achieved good clinical efficacy, are reported below.
1 Materials and Methods
1.1 Case Selection According to the 2000 diagnostic criteria for unstable angina [2]. The 59 cases of patients with UAP were randomly divided into treatment group and control group, treatment group, 30 cases, including 23 males and 7 females, mean age 59.3 ± 11.2 years of age. History of hypertension in 21 cases, history of diabetes in 9 cases. Angina type: onset angina in 11 cases, worsening angina in 13 cases, 4 cases of myocardial infarction, other type 2 cases; control group 29 cases, including 20 males and 9 females. The average age of 60.2 ± 11.7 years of age, history of hypertension, 22 cases of diabetes mellitus in 7 cases. Angina type: onset angina in 10 cases, 14 cases of worsening angina, myocardial infarction, 3 cases, other types of 2 cases. The two groups in age, gender, type of angina and high blood pressure, diabetes and other risk factors for coronary heart disease was no significant difference, comparable. All patients had history of angina and resting EKG are ischemic ST-T changes.
1.2 Two groups of patients were hospitalized bed rest, routinely given nitrates, β-blockers, calcium channel blockers, anticoagulants, antiplatelet drugs, angiotensin-converting enzyme inhibitor treatment. Have high blood pressure, diabetes, high cholesterol who were given the appropriate treatment. Determined dysfunction digitalis preparations and diuretics appropriate treatment given. Treatment group received conventional treatment, based on to TMZ (trade name: Wan Li Shuang, French Servier pharmaceutical production) 20mg treatment, 3 times a day for 8 weeks. The course of treatment, disabling drugs dilate blood vessels, blood circulation, not permitted to interfere with ST-segment changes using drugs such as amiodarone, monoamine oxidase inhibitors, Ma Duoming and dipyridamole and other medications.
1.3, respectively, observed indicators before and after treatment to monitor the following indicators. (1) Holter detection of myocardial ischemia and the total applied load (TIB); (2) the number of ischemic events. Ischemic events include: cardiac death, myocardial infarction, angioplasty, angina deterioration.
1.4 statistical methods of data with x ± s said, differences between groups using t test, the incidence of ischemic events using χ2 test. To P <0.05 for the difference was significant.
2 results
2.1 Holter two groups before and after treatment of myocardial ischemia in patients with total load (TIB) is shown in table 1. Table 1, two groups of patients before and after treatment Holter ischemic events compared
2.2 The overall incidence of ischemic events in the treatment group was significantly lower than the control group (χ2 = 4.73, P <0.05), Table 2. Table 2 groups the occurrence of ischemic events of note: χ2 = 4.73, P <0.05
3 discussions
TMZ is the first clinically for the treatment of coronary heart disease with myocardial protection the role of metabolism of drugs, and has its unique metabolic mechanism: inhibition of mitochondrial long-chain 3 – keto acyl coenzyme A thiolase (3-KAT) that the transfer of energy metabolism from fatty acid oxidation to glucose oxidation, result in more use of limited oxygen more adenosine triphosphate and increased synthesis of phospholipids, thereby enhancing myocardial contractility; and protect the cell membrane to reduce tissue acidosis, increased myocardial tolerance to ischemia [3,4]. TMZ Chinese multi-center clinical study cooperative group [5] and some foreign studies [6] show TMZ for stable angina have more precise results. In this study, Holter TBI evaluation of TMZ on myocardial ischemia in patients with UAP role. Two groups before treatment was no significant difference between TBI (P> 0.05), treatment 2 months after TBI treatment group was significantly less than the control group (P <0.05). TMZ on UAP patients showed significant anti-myocardial ischemia, and can significantly reduce the UAP patients the incidence of ischemia-related events. Therefore, the conventional treatment in patients with UAP, based on the addition of TMZ treatment can enhance its efficacy.
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I: presentation of high quality. Professional writers by serving the master and some experts and scholars, Dr., writing powerful quality assurance.
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References
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