BACKGROUND: Trimetazidine is an anti-ischemic agent with cardioprotective 
effects. The purpose of this double-blind, controlled, prospective randomized 
study was to investigate the possible effects of the preoperative use of 
trimetazidine on the biochemical markers of myocardial injury during open heart 
surgery and to determine if it has any myocardial protective effects.
METHODS: Thirty patients undergoing coronary artery bypass grafting surgery, 
received either trimetazidine (study group, n = 15) or not (control group, n = 
15). Pretreatment began 2 weeks before the operation with trimetazidine (60 
mg/day orally), and the control group received no medication. We measured the 
levels of serum creatine kinase (CK), CK isoenzyme MB (CK-MB), myoglobin, and 
troponin T in venous blood samples obtained before and after the operation to 
evaluate the effect of this drug against myocardial damage. We also took serial 
blood samples from the radial artery and the coronary sinus before the 
institution of cardiopulmonary bypass (CPB) and at 2 and 15 minutes after the 
removal of the cross-clamp to measure lactate levels and calculate the lactate 
extraction of the myocardium.
RESULTS: Postoperative levels of myoglobin, troponin T, CK, and CK-MB were 
significantly lower in the trimetazidine group than in the control group (P < 
.05). There was also a significant difference in the values for the lactate 
extraction calculation between the groups at minute 2 after the removal of the 
cross-clamp (P < .05).
CONCLUSION: We conclude that pretreatment with trimetazidine has some beneficial 
effects in protecting the myocardium and decreasing myocardial injury during the 
cardioplegic arrest period in open heart surgery without affecting postoperative 
hemodynamics.