Patients on DAPT for at least 6 months will be tested for platelet function testing with the P2Y12 VerifyNow assay at baseline. The patients will then undergo at least a 2-week course of Trimetazidine 35 mg/q12h, followed thereafter by platelet function testing.

Platelet Dysfunction Due to Drugs

Trimetazidine is a clinically effective antianginal agent that has no negative inotropic or vasodilator properties (6). It is presently clinically used throughout Europe and in >80 countries worldwide. It is a cytoprotective drug that normalizes metabolic disturbances in low-flow ischemia via several—not yet fully understood—mechanisms of action (7). The best-known mechanism of action is its capacity to inhibit β-oxidation of free fatty acid (FFA) (7).

Trimetazidine

The University of the West Indies

Trimetazidine as an Adjunct to Enhance Clopidogrel Response.

Trimetazidine as an Adjunct to Enhance Clopidogrel Response: The TRACER Study.

The investigators postulate that inhibition of platelet aggregation in response to Clopidogrel may be accentuated by Trimetazidine, i.e. Trimetazidine enhances Clopidogrel response.

All available data can be obtained by contacting the corresponding author.

The University of The West Indies

The study will be of a prospective, randomized, controlled, sequential trial design.

The Outcomes Assessor will be independent of the Clinical Research Associates, i.e. he/she will be analyzing the VerifyNow samples without knowledge of the intervention the patient has received.

L-ornithine L-aspartate (6 ampules, each ampule containing 5 grams of the drug in 10 ml solution) to be diluted in 440 ml of Dextrose 5% (to make a total of 500 ml of solution), as intravenous infusion at the rate of 21 ml/hour, over 24 hours, for 5 days

Placebo (sterile water, 6 ampuoles of 10 ml each) diluted in 440 ml of Dextrose 5%, as intravenous infusion at the rate of 21 ml/hour, over 24 hours, for 5 days

Cirrhosis of Liver

Hepatic Encephalopathy

L-ornithine L-aspartate

Placebo (sterile water, 60 ml) diluted in 440 ml of Dextrose 5%, as intravenous infusion at the rate of 21 ml/hour, over 24 hours, for 5 days

Placebo

Department of Gastroenterology, D.M.C. and Hospital

G.B. Pant Hospital

L-ornithine L-aspartate in Overt Hepatic Encephalopathy

Efficacy of Intravenous 'L-ornithine L-aspartate' in Reversal of Overt Acute Hepatic Encephalopathy in Patients With Liver Cirrhosis: a Prospective, Randomized, Double-blind, Placebo Controlled Trial

Mental state grade according to West Haven criteria for Hepatic encephalopathy

Change in blood ammonia levels will be measured at baseline and after 5 days of treatment

Mortality rate in the two groups at 4 weeks will be compared

The total length of hospital stay (number of days) in each group will be compared.

Change in serum cytokine levels (Interleukin-1, Interleukin-6, Interleukin-10 and TNF-alpha will be measured at baseline and after 5 days of treatment.

lactic acid/uppköst

Trimetazidine as an Adjunct to Enhance Clopidogrel Response.

L-ornithine L-aspartate in Overt Hepatic Encephalopathy

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