Trimetazidin effektiven v reabilitatsii bol'nykh posle protezirovaniya klapanov serdtsa: rezul'taty randomizirovannogo kontroliruemogo godichnogo issledovaniya

It is known that a successful surgery for valvular heart disease increases life expectancy, reduces symptoms and improves cardiac function. Nevertheless, left ventricular dysfunction, heart failure, and impaired quality of life (QOL) may persist and worsen in the postoperative period. We hypothesized that metabolically active drug trimetazidine may improve symptoms and quality of life of patients after heart valve replacement. The study involved 150 patients with valvular heart disease at the age of 55,3 ± 3,2 years (58 % men) who were randomized 1 : 1 to were to either use the optimal standard therapy (vitamin Kantagonists, angiotensin converting enzyme inhibitors/ angiotensin II receptor antagonists, β-blockers, diuretics, statins and digoxin - if indicated) or trimetazidine at a dose of 35 mg twice a day in addition to the traditional therapy 2-4 weeks after surgical replacement of the aortic (n = 84) or mitral (n = 66) valve. Significant baseline differences between the trimetazidine group and the control group were not observed. It was shown that long-term therapy with trimetazidine in patients with mechanical prosthetic aortic/mitral valve improves the clinical status and QoL. This study is the first evidence that trimetazidine may be new additional therapy of patients after heart valve replacement.

valvular heart disease, heart valve replacement, quality of life, trimetazidine