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Acute effects of heparin administration on the ischemic threshold of patients with coronary artery disease

Evaluation of the protective role of the metabolic modulator trimetazidine

Gabriele Fragasso, MD^*,*, Pier Marco Piatti, MD, Lucilla Monti, MD, Altin Palloshi, MD^*, Chunzeng Lu, MD^*, Gianpietro Valsecchi, PhD, Emanuela Setola, MD, Giliola Calori, MD, Guido Pozza, MD, Alberto Margonato, MD, FESC^* and Sergio Chierchia, MD, FESC, FACC^*

^* Dipartimento di Cardiologia e Scienze Cardiovascolari-Unità di Cardiologia Clinica, Università degli Studi di Milano, Istituto Scientifico/Università San Raffaele, Milan, Italy
Cattedra di Clinica Medica, Università degli Studi di Milano, Istituto Scientifico/Università San Raffaele, Milan, Italy
Epidemiologia e Biostatistica, Università degli Studi di Milano, Istituto Scientifico/Università San Raffaele, Milan, Italy

View larger version (25K): [in a new window]   Figure 1 Bar graphs pertaining to the time (seconds; mean ± SD) to 1-mm ST-segment depression, to peak exercise and to the end of the recovery period, during saline and heparin, with placebo and trimetazidine (TMZ). Solid bar = saline and placebo; striped bar = heparin and placebo; checkered bar = heparin and TMZ; open bar = saline and TMZ. Refer to Table 1 for all significance levels, if not shown in figure.

View larger version (23K): [in a new window]   Figure 2 Bar graphs pertaining to the magnitude of maximal ST-segment depression (mm) and to the number of involved electrocardiographic leads (mean values ± SD for both), during saline and heparin, with placebo and trimetazidine (TMZ). Solid bar = saline and placebo; striped bar = heparin and placebo; checkered bar = heparin and TMZ; open bar = saline and TMZ.

View larger version (32K): [in a new window]   Figure 3 Bar graphs pertaining to the rate–pressure product (RPP) (mm Hg x beats/min; mean value ± SD) at 1-mm ST-segment depression and at peak exercise, during saline and heparin, with placebo and trimetazidine (TMZ). Solid bar = saline and placebo; striped bar = heparin and placebo; checkered bar = heparin and TMZ; open bar = saline and TMZ.

View larger version (21K): [in a new window]   Figure 4 Diagram pertaining to free fatty acid (FFA), endothelin-1 (ET-1), nitric oxide (NO) and lactate levels (mean values ± SE) 15 min before exercise testing, at time 0, at peak exercise and 10, 15 and 20 min after exercise testing, during saline and heparin, with placebo and trimetazidine (TMZ). Solid circles = saline and placebo; striped squares = heparin and placebo; checkered squares = heparin and TMZ; open circles = saline and TMZ. *p < 0.01 versus saline and placebo and versus heparin and placebo. #p < 0.01 versus time 0. p < 0.01 versus heparin and placebo and versus heparin and TMZ. p < 0.05 versus heparin and placebo.