PMID- 32801436
OWN - NLM
STAT- MEDLINE
DCOM- 20210706
LR  - 20220416
IS  - 1986-5961 (Electronic)
IS  - 0350-199X (Print)
IS  - 0350-199X (Linking)
VI  - 74
IP  - 3
DP  - 2020 Jun
TI  - Trimetazidine Improves the Outcome of EECP Therapy in Patients with Refractory 
      Angina Pectoris.
PG  - 199-204
LID - 10.5455/medarh.2020.74.199-204 [doi]
AB  - INTRODUCTION: Cardiovascular disease (CAD) associated with death and disability 
      remains a serious medical problem. In some patients the initial clinical coronary 
      artery disease presentation is stable angina pectoris. AIM: The aim of the study 
      was to evaluate the effect of EECP therapy with or without trimetazidine (TMZ) in 
      patients with refractory angina via modulating peripheral monocyte expression of 
      Toll like receptor2 (TLR2) and its downstream signaling. METHODS: This is a 
      double-blind randomized prospective study in which 88 stable refractory angina 
      patients allocated into two groups, Enhanced External Counter Pulsation (EECP) 
      group: included 44 patients with stable refractory angina, and were treated with 
      EECP-Therapy. TMZ-EECP group: included 44 patients with stable refractory angina, 
      we gave TMZ 35 mg twice daily in addition to EECP-Therapy. RESULTS: TLR2 
      expression in peripheral monocyte investigated by flow cytometry and 
      8-iso-prostaglandin F2beta (8-iso-PGF2 beta), interleukin1beta (IL-1beta), heat shock protein 
      60 (HSP60) and monocytes chemoattractant protein-1(MCP-1) were also measured 
      before the EECP-therapy and before giving TMZ to patients, and after 35 hours of 
      EECP treatment (7 consecutive weeks). Inhibition in TLR2 expression in peripheral 
      monocyte was observed among the EECP group (P<0.05). Inflammatory cytokine MCP-1 
      was remarkably decreased in both study groups but (heat shock protein 60 (HSP60), 
      MCP-1 and interleukin-1beta (IL-1beta)) significantly decreased levels were observed 
      among the TMZ-EECP group (P<0.05). Also, the oxidative stress biomarker 
      8-iso-prostaglandin F2beta (8-iso-PGF2beta) was decreased in both study groups but 
      significantly decreased levels were observed among the TMZ-EECP group (P<0.05). 
      TMZ and EECP therapy in patients with stable refractory angina remarkably 
      decreased the inflammatory markers HSP60, MCP-1 and IL-1beta in serum levels also 
      the decreased levels were found in serum levels of oxidative stress marker 
      8-iso-PGF2beta serum level. CONCLUSION: EECP-therapy decreased the expression of 
      TLR2 on peripheral monocytes in patients with chronic stable refractory angina 
      which yield improvement in the quality of patients' life by decreasing the 
      frequency of angina episodes, decreasing the Short-acting nitrate use and change 
      the exercise tolerance and distance.
CI  - (c) 2020 Saad Rasool Shaker, Fadhil Al-Amran, Ghizal Fatima, Hayder Al-Aubaid, 
      Najah R. Hadi.
FAU - Shaker, Saad Rasool
AU  - Shaker SR
AD  - Department of Pharmacology and Therapeutics, Faculty of Medicine, University of 
      Kufa, Iraq.
FAU - Al-Amran, Fadhil
AU  - Al-Amran F
AD  - Department of Cardiothoracic Surgery, Faculty of Medicine, University of Kufa.
FAU - Fatima, Ghizal
AU  - Fatima G
AD  - Department of Biotechnology, Era University, Lucknow, India.
FAU - Al-Aubaid, Hayder
AU  - Al-Aubaid H
AD  - La Trobe University, Australia.
FAU - Hadi, Najah R
AU  - Hadi NR
AD  - Department of Pharmacology and Therapeutics, Faculty of Medicine, University of 
      Kufa, Iraq.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - Bosnia and Herzegovina
TA  - Med Arch
JT  - Medical archives (Sarajevo, Bosnia and Herzegovina)
JID - 101635337
RN  - 0 (8-isoprostaglandin PGF2beta)
RN  - 0 (CCL2 protein, human)
RN  - 0 (Chaperonin 60)
RN  - 0 (Chemokine CCL2)
RN  - 0 (F2-Isoprostanes)
RN  - 0 (HSPD1 protein, human)
RN  - 0 (IL1B protein, human)
RN  - 0 (Interleukin-1beta)
RN  - 0 (Mitochondrial Proteins)
RN  - 0 (TLR2 protein, human)
RN  - 0 (Toll-Like Receptor 2)
RN  - 0 (Vasodilator Agents)
RN  - N9A0A0R9S8 (Trimetazidine)
SB  - IM
MH  - Angina Pectoris/*blood/*therapy
MH  - Chaperonin 60/blood
MH  - Chemokine CCL2/blood
MH  - Combined Modality Therapy
MH  - *Counterpulsation
MH  - Double-Blind Method
MH  - F2-Isoprostanes/blood
MH  - Female
MH  - Humans
MH  - Interleukin-1beta/blood
MH  - Male
MH  - Middle Aged
MH  - Mitochondrial Proteins/blood
MH  - Monocytes/metabolism
MH  - Patient Satisfaction
MH  - Prospective Studies
MH  - Toll-Like Receptor 2/blood
MH  - Trimetazidine/*therapeutic use
MH  - Vasodilator Agents/*therapeutic use
PMC - PMC7406001
OTO - NOTNLM
OT  - Enhanced External Counter Pulsation
OT  - Timetizidine
COIS- The authors declare no conflict of interest.
EDAT- 2020/08/18 06:00
MHDA- 2021/07/07 06:00
PMCR- 2020/06/01
CRDT- 2020/08/18 06:00
PHST- 2020/08/18 06:00 [entrez]
PHST- 2020/08/18 06:00 [pubmed]
PHST- 2021/07/07 06:00 [medline]
PHST- 2020/06/01 00:00 [pmc-release]
AID - 10.5455/medarh.2020.74.199-204 [doi]
PST - ppublish
SO  - Med Arch. 2020 Jun;74(3):199-204. doi: 10.5455/medarh.2020.74.199-204.