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Trimetazidine for stable angina pectoris.

H R Cross1

  • 1Department of Pathology, Box 3712, Duke University Medical Center, Durham NC 27710, USA. cross017@mc.duke.edu

Expert Opinion on Pharmacotherapy
|May 5, 2001
PubMed
Summary

Trimetazidine effectively treats stable angina pectoris symptoms by improving exercise capacity and reducing chest pain. This metabolic agent offers a safe alternative or addition to traditional medications without depressing cardiac function.

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Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Stable angina pectoris is a symptom of coronary heart disease (CHD) causing chest pain during ischaemia.
  • Current treatments include beta-blockers, calcium antagonists, and nitrates, aiming to reduce cardiac workload or improve coronary blood flow.

Purpose of the Study:

  • To evaluate trimetazidine, a metabolic agent, as a treatment for stable angina pectoris.
  • To compare trimetazidine's efficacy and safety against placebo and existing anti-anginal medications.

Main Methods:

  • Systematic review of clinical trials investigating trimetazidine (20 mg t.i.d.) in stable angina patients.
  • Comparison of exercise capacity, anginal incidence, and left-ventricular function between trimetazidine and placebo/active comparators.

Main Results:

  • Trimetazidine significantly improved exercise capacity and decreased anginal episodes compared to placebo.
  • Efficacy was comparable to propranolol and nifedipine, and superior to isosorbide dinitrate in some cases.
  • Trimetazidine demonstrated a favorable safety profile with mild, infrequent adverse effects and no cardiac depression.

Conclusions:

  • Trimetazidine is a safe and effective monotherapy or adjunctive treatment for stable angina symptoms.
  • Further long-term studies are needed to assess its impact on myocardial infarction (MI) and mortality rates.

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