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Trimetazidine and stable angina a double-blind trial
R K Ayudhya1, T Yipintsoi, W Jintapakorn
1Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand.
Summary
Trimetazidine did not improve angina symptoms or exercise tolerance in patients already on standard antianginal medications. This study found no significant benefit of adding trimetazidine to existing treatments for stable angina.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Stable angina remains a significant clinical challenge, necessitating effective therapeutic strategies.
- Current management involves conventional antianginal drugs like nitrates, beta-blockers, and calcium channel blockers.
Purpose of the Study:
- To evaluate the efficacy of trimetazidine as an add-on therapy for patients with stable angina.
- To assess the impact of trimetazidine on anginal symptoms and exercise capacity.
Main Methods:
- A double-blind, crossover study design with 8-week treatment periods.
- Patient evaluation included symptom recall, daily nitrate/discomfort diaries, and exercise stress tests (EST).
- Thirty-six patients with stable angina completed the trial.
Main Results:
- No significant improvement in angina symptoms was observed; 12 patients reported more angina on trimetazidine.
- Exercise stress tests showed no consistent improvement in ischemic changes.
- A dominant placebo effect was not identified.
Conclusions:
- Trimetazidine does not offer additional benefit for angina relief in patients adequately treated with conventional antianginal medications.
- Adding trimetazidine to nitrates, beta-blockers, or calcium blockers is unlikely to improve outcomes in stable angina.