Trimetazidina e resposta inflamatória em cirurgia de revasculariza？？o do miocárdio

background: organic inflammatory response is a pathophysiological mechanism present at every coronary artery bypass grafting with extracorporeal circulation (cabg-ecc), the release of inflammatory mediators being one of its defense mechanisms. objective: to assess, in a prospective double-blind randomized and placebo-controlled study, the effects of trimetazidine (tmz) on the inflammatory response, by using the variation in interleukins 6 and 8, tnf-α, complements c3 and c5, and highly sensitive c-reactive protein (hs-crp) levels in the pre- and post-operative periods. methods: this study assessed 30 patients undergoing cabg-ecc with intermittent hypothermic cardioplegia, and having, at most, mild ventricular dysfunction. the patients were divided into two groups (placebo and tmz), stratified by echocardiography, and received drug/placebo at the dose of 60 mg/day. measurements were taken as follows: in the pre-operative period with no drug; on the day of surgery, corresponding to 12 to 15 days on drug/placebo; five minutes after aortic unclamping; 12 and 24 hours after surgery, for interleukins and complements; and 48 hours after surgery, for hs-crp. results: no significant difference between the levels of interleukin 8, tnf-α, c3 and c5, and hs-crp was observed. however, the interleukin 6 levels were significantly lower in the group treated as compared with those in the control group at all time points assessed. conclusion: trimetazidine proved to be effective only for reducing interleukin 6 in patients undergoing cabg.