Scintigraphic evaluation of the nephroprotective efficacy of trimetazidine in patients undergoing endovascular myocardial revascularization

The aim of the study was to perform scintigraphic evaluation of the renoprotective efficacy of trimetazidine in patients who underwent endovascular myocardial revascularization (EMR). The study included 40 patients with ischemic heart disease (35 men and 5 women with the mean age of 56.98+1.40 years) who underwent EMR (stenting of the coronary arteries). All patients were randomized into 2 groups: patients (n=12) who took trimetazidine before angiographic procedures (group I) and patients (n=28) who underwent ER without nephroprotection (group II). Dynamic radionuclide renoscintigraphy with 99mTc-DTPA was performed before and 2 to 3 days after the ER with the calculation of the parameters of renal filtration and excretory functions. Patients of group II after ER showed negative dynamics in the renal filtration function parameters. Thus, there was a significant decrease in the mean value of the total glomerular filtration rate (GFR) mainly due to reduction in the filtration activity of the left kidney. Patients of this group demonstrated significant increase in the radiopharmaceutical clearance half-time from the renal pelvis system (RPS) and from the parenchyma of both kidneys and decrease in the cortical delay index of the left kidney. In the group of patients who were treated with trimetazidine (group I), mean values of parameters of filtration activity of the kidneys did not significantly change as compared with the baseline (before ER) data. In comparison with filtration activity, adverse changes in the processes of renal excretion were observed more frequently in group I. However, in patients of group I, average changes in the scintigraphic parameters reflecting the evacuation function of the kidney parenchyma and RPS were insignificant. The study showed that trimetazidine prevents contrast-induced renal dysfunction in patients who underwent coronary procedures.