Effects of trimetazidine on cardiac function and ventricular remodeling in patients with ischemic cardiomyopathy: a systematic review and meta-analysis.

Background: Ischemic cardiomyopathy (ICM) is a late manifestation of coronary artery disease, marked by significant deterioration of cardiac pump function and abnormal ventricular remodeling. Current therapies have limitations, driving the search for novel approaches, especially targeting myocardial metabolism, as a key research focus.

Objective: This study aims to systematically evaluate the effects of Trimetazidine (TMZ) on improving cardiac function and delaying ventricular remodeling in patients with ICM.

Methods: Relevant literature was retrieved from five databases: PubMed, Embase, Web of Science, Cochrane Central, and CNKI, covering all studies published to date. A meta-analysis was conducted to assess the impact of trimetazidine on LVEF, E/A ratio, wall motion index, LVEDD, and LVESD, using standardized mean differences (SMD) as the effect measure and calculating the 95% CI.

Results: A total of 9 studies involving 1037 patients were included. The meta-analysis results showed that the LVEF in the trimetazidine treatment group was significantly higher than that in the control group (SMD = 0.64, 95% CI: [0.30, 0.97], p < 0.0001). The E/A ratio and wall motion index also showed improvement (SMD = 0.20, 95% CI: [0.03, 0.36]; SMD = - 0.54, 95% CI: [- 0.78, - 0.29]). However, the effects of trimetazidine on LVEDD and LVESD were not significant (SMD = - 0.36, 95% CI [- 1.09, 0.36]; SMD = - 0.03, 95% CI [- 1.12, 1.07]).

Conclusion: TMZ can effectively improve cardiac function in patients with ischemic cardiomyopathy, but its impact on ventricular remodeling is limited. Future research should further explore its application in the treatment of ICM.