Trimetazidine effects on cardiac biomarkers in acute coronary syndrome

Trimetazidine acts at the cellular level, increasing myocardial glucose oxidation and shifting substrate utilization from fatty acid to carbohydrate metabolism. In an ischemic situation, this promotes the formation of adenosine triphosphate, the main source of cardiac energy, at less oxygen cost. The benefit on myocyte necrosis can be judged by reduction in release of biomarkers such as cardiac troponin, myocardial creatine kinase, brain natriuretic peptide, and interleukin 6. These beneficial effects of trimetazidine have been recorded in patients with acute coronary syndrome, treated medically or by percutaneous intervention or coronary artery bypass graft surgery. What is most gratifying is that these effects on cellular protection are associated with clinical improvement in symptoms, left ventricular function, cardiac events, and even mortality. L Heart Metab. 2015;67:26-29