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Effect of trimetazidine on exercise performance in patients with coronary artery ectasia
Abdullah Dogan1, Mehmet Ozaydin, Omer Gedikli
1Sevket Demirel Heart Centre, Suleyman Demirel University, Isparta, Turkey.
Insights
Trimetazidine effectively relieved exercise-induced angina and improved exercise capacity in patients with coronary artery ectasia (CAE). This study found reduced ischemia and enhanced performance with trimetazidine therapy in CAE patients.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary artery ectasia (CAE) is a rare coronary artery disease.
- Nitrate derivatives can induce exertional angina in CAE patients.
- Limited data exists on other anti-ischemic agents in CAE.
Purpose of the Study:
- To investigate the effect of trimetazidine on exercise performance in patients with isolated CAE.
- To assess trimetazidine's impact on exercise-induced angina and myocardial ischemia.
Main Methods:
- A study involving 56 patients with isolated CAE.
- Treadmill exercise tests were used to evaluate myocardial ischemia and exercise capacity.
- Patients underwent exercise testing at baseline and during trimetazidine therapy.
Main Results:
- Trimetazidine therapy significantly reduced positive exercise tests (49 to 27 patients) and ST depressions (42 to 23 patients).
- The extent of ST depression at peak exercise was significantly lower with trimetazidine.
- Exercise duration and cardiac workload (mets) significantly increased with trimetazidine treatment.
Conclusions:
- Trimetazidine demonstrates potential in relieving exercise-induced angina in CAE patients.
- Trimetazidine improves exercise performance and reduces myocardial ischemia in CAE.
- Further research into trimetazidine for CAE management is warranted.
Abstract:
Coronary artery ectasia (CAE) is a rare form of coronary artery disease. It has previously been shown that nitrate derivatives induce exertional angina in patients with CAE. Furthermore, there is limited data about the effects of other anti-ischemic agents in CAE. The aim of this study was to investigate the effect of trimetazidine on exercise performance in patients with CAE. The study population consisted of 56 patients with isolated CAE (32 males, mean age: 58 +/- 9 years). The presence of myocardial ischemia was evaluated by treadmill exercise test. The exercise test was positive in 49 patients at baseline and in 27 patients during trimetazidine therapy (P < 0.01). The exercise test induced angina in all of the patients who have had a positive test result. Significant ST depressions were observed in 42 and 23 patients before and after the treatment, respectively (P < 0.01). The extent of ST depression at peak exercise was significantly lower on trimetazidine (0.9 +/- 0.5 vs 1.5 +/- 0.6 mm, P < 0.01). With trimetazidine, the exercise duration increased from 7.8 +/- 2.1 to 8.7 +/- 2.4 min (P = 0.04) and cardiac work-load also increased from 8.9 +/- 2.3 to 10.4 +/- 2.1 mets (P < 0.01). The results suggest that trimetazidine can relieve exercise-induced angina and improve exercise performance in patients with CAE.