Impact of Trimetazidine on Major Adverse Cardiac Events in Asian Patients with Acute Myocardial Infarction: A Systematic Review

Abstract

Aims: The review aims to assess the effect of ongoing treatment with trimetazidine on the incidence of major adverse cardiac events (MACE) in Asian patients with acute myocardial infarction (AMI). Methodology: A systematic literature review of the journal articles evaluating the impact of trimetazidine on the incidence of MACE was performed. Two real-world studies recruiting Asian patients who were hospitalized and on trimetazidine treatment for AMI were included. Both the studies evaluated the incidence of MACE post-AMI. Results: The KAMIR study (N=1304), with a 12-month follow-up period, reported that the risk of all-cause death was lower by 59% (incidence rate 2.3 vs 6.4%; hazard ratio 0.41, 95% CI 0.18–0.97, P = .042) and the risk of MACE was lower by 76% (incidence rate 2.3 vs 9.5%; hazard ratio 0.24, 95% CI 0.10–0.56, P = .001) in the trimetazidine group vs the non-trimetazidine group. According to the METRO study (N=353), with a 6-month follow-up period, the mean discharge-to-6-month all-cause mortality risk was predicted to be 5% as per the Global Registry of Acute Coronary Events (GRACE) prediction score card and nomogram. All 353 patients receiving antianginal drugs prior to MI had lower predicted discharge-to-6-month all-cause mortality score; however, the reduction was only significant in patients receiving trimetazidine (P = .022). Conclusion: The analysis of data suggests that the use of trimetazidine as an antianginal medication does have a beneficial effect in patients with AMI: it decreases the incidence of MACE post-AMI in patients.