[Ergometric effects of a single administration of trimetazidine]

The effects on exercise capacity of a single oral dose of 60 mg of trimetazidine were studied during a double-blind, placebo controlled cross-over study. Ten patients with stable angina and angiographically proven coronary artery lesions underwent ergometric bicycle exercise tests before and two hours after administration of the drug. A blood sample, for trimetazidine levels, was taken at the end of the recovery period. The homogeneity of the group and the lack of significance of the order of administration were established by cross-over analysis of the "control" tests and the "treated" tests. As compared with placebo, a statistically significant difference was noted after trimetazidine in the following parameters: total work (+31%, P less than 0.02), duration of exercise (+17%, P less than 0.02), percentage of the predicted maximal heart rate reached (+4%, P = 0.05), time to 1 mm ST segment depression (+17%, P less than 0.05) and degree of ST depression at maximum exercise level of the first control test (-31%, P less than 0.05); there was no significant difference in heart rate, blood pressure at rest and rate-pressure product during exercise between treatment and placebo. Two patients showed no response to trimetazidine. In the eight patients who did respond, there was a correlation factor of 0.73 between the plasma levels of trimetazidine and the increase in work performed. In conclusion, a single 60 mg dose of trimetazidine improves exercise tolerance and delays the ischaemic threshold during exercise without any detectable peripheral haemodynamic effects.