Skip to main content
Log in

Effect of Trimetazidine on Late Potentials After Acute Myocardial Infarction

  • Published:
Cardiovascular Drugs and Therapy Aims and scope Submit manuscript

Abstract

Summary. The purpose of this study was to evaluate the effect of trimetazidine on late potentials in patients with acute myocardial infarction. A total of 60 patients (52 males, mean age 55 ± 2 years, and 8 females, mean age 54 ± 1.8 years) with the diagnosis of acute myocardial infarction were included in this study. The study was designed as a randomized, double-blinded, and placebo-controlled trial. Signal-averaged electrocardiography and echocardiography were performed during the first 2 days of acute myocardial infarction and were repeated between days of 8 and 15 (mean 11). Patients were treated with trimetazidine (n = 30) or placebo (n = 30). In the placebo group, the total filtered QRS duration and low-amplitude terminal signal duration increased (from 102.7 ± 1.8 ms to 113.3 ± 1.8 ms, and from 32.2 ± 0.9 ms to 38.3 ± 1.1 ms; P < 0.001), the root mean square voltage of the terminal 40 ms of the QRS decreased (from 28.6 ± 2.1 µV to 21.4 ± 1.3 µV; P < 0.001), and the incidence of late potentials increased (from 30% to 46%; P < 0.01) significantly. In the trimetazidine group, these measurements were a decrease from 102.9 ± 1.9 ms to 100 ± 2.0 ms (NS), an increase from 31.6 ± 0.9 ms to 32.5 ± 0.9 ms (NS), a decrease 29.3 ± 2.0 µV to 27.3 ± 1.8 µV (P < 0.01), and a decrease from 33% to 30% (NS), respectively. The ejection fraction was 47.1 ± 1.3% to 50.8 ± 1.2% in the placebo group (P = 0.05), and 48.1 ± 1.1% to 53.4 ± 1.2% (P < 0.01) in the trimetazidine group. It is concluded that trimetazidine reduces late potentials after acute myocardial infarction without changing blood pressure and heart rate.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Makijarvi M, Fetsch T, Reinhard L, et al. Comparison and combination of late potentials and spectral turbulance analysis to predict arrhythmic events after myocardial infarction in the post-infarction late potential (PILP) study. Eur Heart 1995;16:651–659.

    Google Scholar 

  2. Zaman AG, Morris JL, Smylie JH, Cowan JC. Late potentials and ventricular enlargement after myocardial infarction. A new role for high resolution electrocardiography? Circulation 1993;88:904–914.

    Google Scholar 

  3. Wong CB, Windle JR. Clinical applications of signal averaged electrocardiography in patients after myocardial infarction. Nebr Med J 1994;79:28–31.

    Google Scholar 

  4. Bricaud H, Brottier L, Barat JL, Combe C, Boussens B, Bonnet J. Cardioprotective effects of trimetazidine in severe ischemic cardiomyopathy. Cardiovasc Drugs Ther 1990;4:861–866.

    Google Scholar 

  5. Renaud JF. Internal pH, NaN1 and Ca;+ N1 regulation by trimetazidine during cardiac cell acidosis. Cardiovasc Drugs Ther 1988;1:677–686.

    Google Scholar 

  6. Pallandi RT, Perry MA, Campbell TJ. Proarrhythmic effects of an oxygen derived free radical generating systems on action potentials recorded from guinea pig ventricular myocardium: A possible cause of reperfusion-induced arrhythmias. Circ Res 1987;61:50–54.

    Google Scholar 

  7. Vedrinne C, Sebbag L, Arvieux C, et al. Effect of trimetazidine on postischemic regional myocardial stunning in the halothane-anesthetized dog. J Cardiovasc Pharmacol 1996;28:500–506.

    Google Scholar 

  8. Kuchar DL, Thornburn CW, Sammel NL. Prediction of serious arrhythmic events after myocardial infarction; Signal averaged electrocardiogram, Holter monitoring and radionuclide ventriculography. J Am Coll Cardiol 1987;9:531–538.

    Google Scholar 

  9. Gomez JA, Winters SL, Stewart D, Horowitz S, Milner M, Barreca P. A new noninvasive index to predict sustained ventricular tachycardia and sudden death in the first year after myocardial infarction: Based on signal averaged electrocardiogan, radionuclide ejection fraction and Holter monitoring. J Am Coll Cardiol 1987;10;349–357.

    Google Scholar 

  10. Berbari EJ, Lazzara R. An introduction to high resolution ECG recordings of cardiac late potentials. Arch Intern Med 1988;148:1859–1863.

    Google Scholar 

  11. Gang ES, Lew AS, Hong M, Wang FZ, Siebert CA, Peter T. Decreased incidence of ventricular late potentials after successful thrombolytic therapy for acute myocardial infarction. N Engl J Med 1989;321:712–716.

    Google Scholar 

  12. Turitto G, Risa AL, Zanchi E, Patri PL. The signal averaged electrocardiogram and ventricular arrhythmias after thrombolysis for acute myocardial infarction. J Am Coll cardiol 1990;15:1270–1276.

    Google Scholar 

  13. Chew EW, Morton P, Murtagh JG, Scott ME, O'Keeffe DB. Intravenous streptokinase for acute myocardial infarction reduces the occurrence of ventricular late potentials. Br Heart J 1990;64:5–8.

    Google Scholar 

  14. Malik M, Kulakowski P, Udemuyima U, et al. Effect of thrombolytic therapy on the predictive value of signal-averaged electrocardiography after acute myocardial infarction. Am J Cardiol 1992;70:21–25.

    Google Scholar 

  15. Santarelli P, Lanza GA, Natale A, et al. Does thrombolysis reduce the value of late potentials for risk stratification after myocardial infarction? (abstr) J Am Coll Cardiol 1992;19:264.

    Google Scholar 

  16. De Leiris J, Boucher F. Rationale for trimetazidine administration in myocardial ischemia-reperfusion syndrome. Eur Heart J 1993;14(Suppl. G):34–40.

    Google Scholar 

  17. EMIP-FR Pilot Study Group. Free radicals, reperfusion and myocardial infarction therapy: European Myocardial Infarction Project-Free Radicals Pilot Study. Eur Heart J 1993;14(Suppl. G):48–51.

    Google Scholar 

  18. Kloner RA, Przyklnk K, Whittaker P. Deleterious effects of oxygen radicals in ischemia/reperfusion: Resolved and unresolved issues. Circulation 1989;80:1115–1127.

    Google Scholar 

  19. Barrington PL. Effect of free radicals on the electrophysiological function of cardiac membranes. Free Radic Biol Med 1990;9:355–365.

    Google Scholar 

  20. Simson MB. Use of signals in the terminal QRS complex to identify patients with ventricular tachycardia after myocardial infarction. Circulation 1981;64:235–241.

    Google Scholar 

  21. Josephson ME, Simson MB, Harken AH, Horowitz LN, Falcone RA. The incidence and clinical significance of epicardial late potentials in patients with recurrent sustained ventricular tachycardia and coronary artery disease. Circulation 1982;66:1199–1204.

    Google Scholar 

  22. Gomez JA, Mehna R, Barreca P, El-Sherif N, Hariman R, Holtzman R. Quantificative analysis of the high frequency components of the signal averaged QRS complex in patients with acute myocardial infarction. A prospective study. Circulation 1985;72:105–111.

    Google Scholar 

  23. De Leiris J, Opie LH. Trimetazidine: Experimental aspects. In: Messerli F, ed. Cardiovascular Drug Therapy. Philadelphia: W.B. Saunders, 1996:1594–1600.

    Google Scholar 

  24. Harpey C, Labrid C, Baud L, et al. Evidence for antioxidant properties of trimetazidine. (abstr). Presented at Xth International Congress of Pharmacology, Sydney (Australia), August 23–28, 1987:648.

  25. Perletti G, Monti E, Paracchini L, Piccinini F. Effects of trimetazidine on early and delayed doxorubicin myocardial toxicity. Arch Intern Pharmacodyn Ther 1989;302:280–289.

    Google Scholar 

  26. Sugimato J, Nagata M, Fugono R, et al. Strophantin-G toxicity and sodium ions. Jpn Circ J 1970;34:725–732.

    Google Scholar 

  27. Mickle DAG, Li RK, Weisel RD, et al. Myocardial salvage with trolox and ascorbic acid for an acute evolving infarction. Ann Thorac Surg 1989;47:553–557.

    Google Scholar 

  28. Klein HH, Pich S, Lindert S, Nebendahl K, Niedman P, Kreuzer H. Combined treatment with vitamin E and C in experimental myocardial infarction in pigs. Am Heart J 1989;118:667–673.

    Google Scholar 

  29. Noble MI, Belcher PR, Drake-Holland AJ. Limitation of infarct size by trimetazidine in the rabbit. Am J Cardiol 1995;76:41B–44B.

    Google Scholar 

  30. Demaison L, Fantini E, Sentex E, Grynberg A, Athias P. Trimetazidine: In vitro influence on heart mitochondrial function. Am J Cardiol 1995;76:31B–37B.

    Google Scholar 

  31. Coetzee WA, Enous R, Opie LH. Trimetazidine: Effects on delayed afterdepolarizations (DADs) and upstroke velocity of the action potential, (abstr). Cardiovac Drugs Ther 1990;4:806–807.

    Google Scholar 

  32. Papadopoulos CL, Kanonidis IE, Kotridis PS, et al. The effect of trimetazidine on reperfusion arrhythmias in acute myocardial infarction. Int J Cardiol 1996;55:137–142.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Özdemir, R., Tuncer, C., Aladağ, M. et al. Effect of Trimetazidine on Late Potentials After Acute Myocardial Infarction. Cardiovasc Drugs Ther 13, 145–149 (1999). https://doi.org/10.1023/A:1007740311072

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1007740311072

Navigation