Improvement Of Coronary Artery Stiffness By Trimetazidine In Women Population

Objective:To study the effect of trimetazidine on coronary artery stiffness by the parameters of brachial ankle pulse wave velocity and the brachial ankle pressure index and explored their relationship with cardiovascular diseaseExperimental method:During March 2013 to December 2014,152 qualified women patients with the results of coronary angiograms were selected, aging 59.45±11.56 years old (46-81 years old). Then, they were randomly divided into control group (n=76) and Trimetazidine treatment group (n=76). In control group, aspirin, clopidogrel, low molecular weight heparin, nitrates, statins, beta blockers, ACEI were given. In study group, trimetazidine in the dose of 60mg per day was added. brachial ankle pulse wave velocity and the brachial ankle pressure index were applied to measure artery stiffness.Results:In the control group, no significant difference exsited in brachial ankle pulse wave velocity and brachial ankle index before and after treatment. In study group, brachial ankle pulse wave velocity decreased from 1656.96±379.16 cm/s to 1556.72±313.18 cm/s after treatment (p<0.05). Brachial ankle index reduced from 1.08±0.15 to 1.05±0.19 after treatment (p>0.05). There was no significant difference in brachial ankle pulse wave velocity and brachial ankle index between two groups (p<0.05). By multivariate regression analysis, age and systolic blood pressure was the main factors on ankle brachial pulse wave velocity (r=0.436, P<0.01; r=0.587, P<0.01). Brachial ankle pulse wave velocity was positively correlated with the severity of coronary artery disease (p<0.05). In addition, the patients with diabetes mellitus and high fasting blood glucose were the risk factors for brachial ankle index.Conclusion:Age and systolic blood pressure were the main factors influencing artery stiffness. Artery stiffness were closely related to coronary lesions.Diabetes, high fasting blood glucose and pulse pressure were the risk factors of artery stiffness Comparing trimetazidine with epinephrine, norepinephrine and angiotensin, it could reduce blood vessel resistance, expand coronary artery, increase coronary blood flow and peripheral blood flow, promote the generation of myocardial metabolism and myocardial energy and reduce cardiac work load and the oxygen consumption of myocardium and myocardial energy consumption. In order to improve the balance of the myocardial oxygen supply, the pulse wave velocity of the artery, improvement of arterial stiffness and may improve insulin resistance, improve vascular endothelial function, reduce the proliferation of vascular smooth muscle and reduce the deposition of lipid.