Effectiveness of Trimetazidine in Patients with Chronic Heart Failure Stratified by the Expression of Soluble Suppression of Tumorigenicity-2 (sST2): A Prospective Cohort Study

Introduction Trimetazidine has been reported to have potential benefits in patients with chronic heart failure (CHF). Soluble suppression of tumorigenicity-2 (sST2) was shown to worsen CHF and, hence, has a diagnostic value in heart failure. The aim of the present study was to evaluate the effectiveness of trimetazidine in patients expressing high and low levels of sST2 compared with their matched placebo. Methods In this prospective cohort study, 170 patients were enrolled. Patients expressing more than 35 ng/mL sST2 (S+) were split into a trimetazidine group (group A) and placebo group (group B). Likewise, patients expressing 35 ng/mL or less of sST2 (S−) were divided into a trimetazidine (group C) and placebo group (group D). Patients in both the trimetazidine groups were administered 20-mg twice-a-day doses of trimetazidine. Trimetazidine effectiveness was determined in terms of changes in cardiac function, motor function, and mental status at 1, 3, 6, and 12 months from baseline among the four groups. Results A total of 158 patients were included for final data analysis (group A, n = 50; group B, n = 57; group C, n = 27; group D, n = 24). On comparing different outcomes between the four groups and across the time points, significant difference was observed between the groups in ejection fraction (EF; P