Chinese Medical Sciences Journal ›› 2020, Vol. 35 ›› Issue (3): 226-238.doi: 10.24920/003678
• Original Article • Previous Articles Next Articles
Effect of Trimetazidine on Diabetic Patients with Coronary Heart Diseases: A Meta-Analysis of Randomized, Controlled Trials
Lin Ye1, Wang Zhenlian1, Yan Min1, Zhu Feiyu1, Duan Ye1, Sun Zhiqin2, *(
)
- 1School of Pharmacy, Changzhou University, Changzhou 213164, China
2Changzhou No. 2 People's Hospital, Changzhou 213164, China
-
Received:2020-01-13Published:2020-09-30Online:2020-09-25 -
Contact:Sun Zhiqin E-mail:sun_zhiqin@163.com
Cite this article
Lin Ye, Wang Zhenlian, Yan Min, Zhu Feiyu, Duan Ye, Sun Zhiqin. Effect of Trimetazidine on Diabetic Patients with Coronary Heart Diseases: A Meta-Analysis of Randomized, Controlled Trials[J].Chinese Medical Sciences Journal, 2020, 35(3): 226-238.
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Figure 1.
Flow diagram of selecting eligible studies included in the meta-analysis. RCT: randomized controlled trials."
Figure 1.
Table 1
The general features of the 8 trials"
| Study | Study design | Location | Number of case | Group (n) | Male (n) | Age (mean, yrs) | Treatment | Inclusion criteria | Outcomes | Follow-up (mon) |
|---|---|---|---|---|---|---|---|---|---|---|
| Fragasso et al.[ | Crossover | Canada | 16 | T (8) C (5) | 8 5 | 64 64 | 20 mg TMZ tid placebo | DM, ischemic cardiomyopathy, LVEF≤45% | Echocardiogram, exercise tolerance, glucose levels, HbA1c, ET-1 | 6 |
| Rosano et al.[ | Parallel | Italy | 32 | T (16) C (16) | 11 13 | 66 65 | 20 mg TMZ tid placebo | DM, ischemic cardiomyopathy, LVEF<50% | Echocardiogram | 6 |
| Marazzi et al.[ | Parallel | Italy | 63 | T (15) C (15) | 12 10 | 66 68 | 20 mg TMZ tid placebo | DM, chronic stable angina | Number and duration of silent and symptomatic ischemia episodes | 6 |
| Ribeiro et al.[ | Crossover | Brazil | 10 | T (5) C (5) | 6 | 62 | 20 mg TMZ tid placebo | DM, stable angina | Clinical and biochemical evaluations, exercise testing, 24-hour ambulatory blood pressure, Holter monitoring | 1.5 |
| Belardinelli et al.[ | Parallel | Italy | 35 | T (19) C (15) | 16 13 | 54 54 | 20 mg TMZ tid placebo | DM, ischemic cardiomyopathy | Myocardial scintigraphy, blood chemistry | 3 |
| Shehata et al.[ | Parallel | Egypt | 100 | T (50) C (50) | 31 29 | 60 59 | 70 mg LD+35 mg TMZ bid placebo | DM, anterior wall STEMI treated with thrombolysis | Myocardial enzyme, degree of ST-segment resolution, echocardiogram, adverse events | 6 |
| Xu et al.[ | Parallel | China | 510 | T (255) C (255) | 172 174 | 69 69 | 20 mg TMZ tid placebo | DM, multivessel CHD after DES implantation | Incidence of recurrent angina pectoris, echocardiographic, clinical outcomes | 24 |
| Li et al.[ | Parallel | China | 180 | T (89) C (84) | 62 58 | 63 64 | 60 mg LD+20 mg TMZ tid placebo | DM, AMI undergoing PCI | Myocardial enzyme, liver function, glucose levels, echocardiogram | 0.5 |
Table 1
Figure 2.
Quality assessment of included studies. A. Risk of bias summary: The assessment of the percentage of all RCTs that have the risk of bias in the analysis; B. Risk of bias summary: The assessment of all the biases of each study in the analysis. +: low risk; -: high risk; ?: unclear."
Figure 2.
Figure 3.
Forest plots for left ventricular function of diabetic patients with CHD additionally used TMZ vs. the controls. A. LVEF; B. left ventricular end diastolic diameter; C. left ventricular end systolic diameter."
Figure 3.
Figure 4.
Forest plots for serum glucose metabolism of diabetic patients with CHD treatment with TMZ vs. those with conventional treatment. A. fasting blood glucose; B. HbA1c."
Figure 4.
Figure 5.
Forest plots for serum lipid profile of the TMZ and the control groups. A. triglyceride; B. total cholesterol; C. low-density lipoprotein cholesterol; D. high-density lipoprotein cholesterol."
Figure 5.
Figure 6.
Forest plot for myocardial ischemia episodes of the TMZ and the control groups."
Figure 6.
Figure 7.
Forest plot for exercise tolerance of the TMZ and the control groups."
Figure 7.
Figure 8.
Forest plot of subgroup analysis for left ventricular end diastolic diameter based on treatment duration."
Figure 8.
Table 2
Sensitivity analysis of left ventricular end systolic diameter"
| Study omitted | WMD (95%CI) | P for heterogeneity | I2(%) |
|---|---|---|---|
| Fragasso et al.[ | -4.83 (-9.08, -0.59) | <0.00001 | 99 |
| Rosano et al.[ | -2.67 (-3.31, -2.03) | 0.88 | 0 |
| Xu et al.[ | -6.99 (-7.64, -6.33) | 0.51 | 0 |
Table 2
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