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The aim of this randomised, double-blind, placebo controlled, parallel group study was to assess the effect of trimetazidine (TMZ), a potent antiischaemic drug, on plasma C-reactive protein (C-RP), cytokine and adhesion molecule levels. The study population consists of 18 patients (16 males, 2 females, average age 56.45 ± 10.97 years) with acute myocardial infarction admitted within 6 hours after onset of symptoms and treated with streptokinase. Blood samples were taken at 3-hour intervals during the time of treatment. All patients were randomised blindly using a centralised randomisation process, between trimetazidine (40mg bolus iv. then 60mg per day for 48 hours intravenously in glucose infusion) or placebo group. Plasma C-RP level was significantly lower in TMZ group (39.5mg/ml ± 9.7 mg/ml) as compared to placebo (75.7 ± 29.4 mg/ml, p≤0.001) and peaked 28 hours later in TMZ group. Plasma interleukin 6 (IL 6) level showed a sharp peak 9 hours after the onset of the symptoms in TMZ group (116.9 ± 180.2 pg/ml vs. 45.4 ± 37.9 pg/ml) and was increased up to 30 hours after the onset of the symptoms. Plasma interleukin 1 beta (IL 1β) was also higher in TMZ group notably 21 hours after the onset of symptoms (26.4 ± 9.3 pg/ml vs. 16.2 ± 2.4 pg/ml). TMZ group showed lower plasma E-selectin levels. Plasma IL 8, TNF α and ICAM 1 levels were without statistical significant differences. The present study demonstrates a significant reduction of plasma C-reactive protein level in the course of acute myocardial infarction treated with streptokinase and intravenous trimetazidine infusion compared with the group of patients without trimetazidine treatment.

The Effect of Trimetazidine on C-Reactive Protein, Cytokines and Adhesion Molecules in the Course of Acute Myocardial Infarction