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Trimetazidine management: an extraordinary clinical response in patients with heart failure (TRIMEX-Study)

Session Poster Session 2

Speaker Eduardo Julian Jose Chuquiure

Event : Heart Failure 2019

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Pharmacotherapy
  • Session type : Poster Session

Authors : EJJ Chuquiure (Mexico City,MX), O Fiscal-Lopez (Mexico City,MX), M Balbuena-Madera (Mexico City,MX), D Garcia-Romero (Mexico City,MX), M Chuquiure-Gil (Monterrey,MX), C Silva-Ruz (Mexico City,MX), E Tamez-Priego (Mexico,MX), E Fiscal-Ruiz (Mexico,MX), D Aragon-Jimenez (Mexico,MX), E Vidal-Copal (Poza Rica,MX), E Martos-Zuleta (Poza Rica,MX), N Hernandez-Isidro (Mexico City,MX), K Jacobo-Garcia (Mexico City,MX), C Sanchez-Ramirez (Mexico City,MX), A Mendez-Ortiz (Mexico City,MX)

Authors:
EJJ Chuquiure1 , O Fiscal-Lopez2 , M Balbuena-Madera2 , D Garcia-Romero2 , M Chuquiure-Gil3 , C Silva-Ruz2 , E Tamez-Priego4 , E Fiscal-Ruiz4 , D Aragon-Jimenez4 , E Vidal-Copal5 , E Martos-Zuleta5 , N Hernandez-Isidro2 , K Jacobo-Garcia2 , C Sanchez-Ramirez2 , A Mendez-Ortiz2 , 1Instituto Nacional de Cardiologia "Ignacio chavez" - Mexico City - Mexico , 2Instituto Nacional de Cardiologia Ignacio Chavez, Centro en Insuficiencia Cardiaca - Mexico City - Mexico , 3Instituto Tecnologico de Estudios Superiores de Monterrey, Escuela de Medicina - Monterrey - Mexico , 4Instituto Politecnico Nacional, Escuela superior de medicina - Mexico - Mexico , 5Universidad Veracruzana, Facultad de Medicina - Poza Rica - Mexico ,

Citation:

Ischemic heart disease (IHD) is the main cause associated with heart failure (HF), generating high mortality and hospitalization rates.  Our purpose was to evaluate clinical prognosis, mortality and  functional capacity of Trimetazidine (TRI) in patients with HF associated with IHD.

MATERIAL AND METHOD

Consecutively both genders patients, over 18 years old with HF and IHD diagnosis according to ESC clinical guidelines were included. They receive standardized treatment. We excluded patients with acute myocardial infarction, cerebrovascular disease/transient ischemic attack or clinical decompensation in the last 6 months. Oral 35 mg of TRI was added every 12 hours. In follow-up mortality, clinical deterioration and hospitalization was evaluated.

RESULTS

Basal: We included 31 patients, only one woman. History of: Diabetes 39.1%, Hypertension 52.2%, Myocardial infarction 73.9%, Angioplasty 26.1%, CABG 13% and smoking 52.2% . 78.3% were in I-II NYHA class.  Angina in 56.5%, Exertional Dyspnea 87%, Dyspnea at rest 47.8%. BMI  28.1± 4.5 Kg/m2. (34.8% were obese) Systolic BP 124.0±22.9 mmHg, LVEF: 33.2±10.3 (HFrEF:69.6 %). Sinus rhythm in 82.6%, Resynchronization therapy (CRT) in 13%%. Labs: Creatinine 1.4±1.0 mg/dL, Sodium 136.9±2.4 mEq/L, NT-pro-BNP:5285.2±284.7 pg/ml.  Basal clinical index risk scores: GRACE 106.2 (52-148), MAGGIC 18.7±6.5  (7-31), EMPHASIS 4.7±6.5(2-10). Treatment: ACE-I 87%, betablockers 78.3%, spironolactone 74%, aspirin 73.9%. Preceding TRI Global Readmission rate (GRR) were 52.2%.

Follow-up (90 days). 87% were in NYHA class I-I. Exertional Dyspnea 39.1% (47.9% reduction, p<0.001), Dyspnea at rest 21.7% (26.1% reduction, p<0.001),  Angina 4.3%1 (52.2% reduction, p<0.001). NT-pro-BNP 1994.5±221.5 pg/ml (p<0.05). No statistics differences in LVEF and serum creatinine. Treatment: ACE-I 95.7%, (increase 8.7%). Readmission rates were: HF: 8.3%, Non-cardiac: 5.9% , and GRR: 13.7%;(-38.5% reduction p<0.001). No Ischemic hospitalization. No mortality observed.

CONCLUSIONS With oral TRI addition to standard treatment, We observed a significant decrease in  ischemia and HF clinical symptoms. Reduction in HF, ischemia and global hospitalization. No mortality was documented.

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