Influence of trimetazidine combined with clopidogrelon carotid atherosclerotic plaques and inflammatory factors of patients with coronary heart disease

  Objective  To investigate the effect of trimetazidine combined with clopidogrel on carotid atherosclerotic plaques and inflammatory factors of patients with coronary heart disease.

  Methods  Totally 126 patients with coronary heart disease were randomly divided into trimetazidine group, clopidogrel group and combined treatment group. Patients in the three groups received routine treatment. Trimetazidine group was given trimetazidine, clopidogrel group was given clopidogrel, and combined treatment group was given trimetazidine and clopidogrel. The intima-media thickness (IMT), carotid atherosclerotic plaque area, plaque diameter and plaque thickness of the three groups were compared before treatment and 6 months after treatment, and the laboratory indexes tumor necrosis factor-α (TNF-α), hypersensitive C-reactive protein (hs-CRP), nitric oxide (NO), human endothelin-1 (ET-1) and therapeutic effect of the three groups were compared.

  Results  After treatment, IMT, plaque volume, plaque diameter and plaque thickness in clopidogrel group were significantly smaller than those in trimetazidine group (P < 0.01), while IMT, plaque volume, plaque diameter and plaque thickness in combined treatment group were significantly smaller than those in other two groups (P < 0.01). The serum levels of TNF-α, hs-CRP and ET-1 in trimetazidine group were significantly lower than those in clopidogrel group, and the serum NO level was significantly higher than that in clopidogrel group (P < 0.01). The serum levels of TNF-α, hs-CRP and ET-1 in combined treatment group were significantly lower than those in other two groups, and the serum NO level was significantly higher than that in other two groups (P < 0.01). The total effective rate of combined treatment group was 97.60%, which was significantly higher than 83.30% of trimetazidine group and 81.00% of clopidogrel group (P < 0.05).

  Conclusion  Trimetazidine combined with clopidogrel is effective in the treatment of patients with coronary heart disease, which can significantly reduce carotid atherosclerosis plaque, reduce serum levels of TNF-α and hs-CRP, improve vascular endothelial function and improve prognosis of patients.