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Trimetazidine for stable angina.
A Ciapponi1, R Pizarro, J Harrison
1Hospital Italiano de Buenos Aires, Division of Family and Preventive Medicine, Peron 4272, Buenos Aires, Argentina 1199. agustin.ciapponi@hospitalitaliano.org.ar
The Cochrane Database of Systematic Reviews
|October 20, 2005
Summary
Trimetazidine effectively reduces angina symptoms and nitroglycerin use compared to placebo. This anti-anginal drug may also lead to fewer adverse event dropouts, but more research is needed.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Standard treatments for stable angina include nitrates, beta-blockers, and calcium channel blockers, often used in combination.
- Combinations may lead to adverse effects or contraindications.
- Alternative treatments are needed, especially in developing countries where revascularization is inaccessible.
Purpose of the Study:
- To evaluate the efficacy and tolerability of trimetazidine for stable angina.
Main Methods:
- A systematic review of randomized controlled trials was conducted.
- Searches included Cochrane Central Register, MEDLINE, EMBASE, LILACS, and SCISEARCH up to October 2003.
- Two reviewers assessed trial quality and extracted data.
Main Results:
- Twenty-three studies with 1378 patients were included.
- Trimetazidine significantly reduced weekly angina attacks and nitroglycerin consumption compared to placebo.
- Exercise tolerance improved, but data on mortality and cardiovascular events were limited.
Conclusions:
- Trimetazidine demonstrates efficacy in treating stable angina, outperforming placebo.
- The drug appears to have a favorable side effect profile, potentially causing fewer dropouts.
- Further large-scale, long-term trials are necessary to define trimetazidine's role in clinical practice.