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Published on: August 28, 2018
[Effectiveness of trimetazidine prolong in stable coronary artery disease. Multicenter, prospective, observational
János Tomcsányi1, László Szakács2
1Kardiológia, Betegápoló Irgalmasrend Budai Irgalmasrendi Kórháza Budapest, Árpád fejedelem útja 7., 1023.
Insights
Daily trimetazidine prolong 80 mg significantly reduced angina frequency and severity in stable coronary artery disease patients. This treatment improved Canadian Cardiovascular Society class, demonstrating its effectiveness in real-world outpatient management.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Medicine
Background:
- The management effectiveness for stable coronary artery disease (CAD) in outpatients remains unclear.
- Many patients continue to experience angina despite existing medical treatments.
Purpose of the Study:
- To assess the impact of once-daily trimetazidine prolong 80 mg on angina frequency and severity.
- To evaluate trimetazidine's effect on Canadian Cardiovascular Society (CCS) class in stable CAD patients.
Main Methods:
- A 3-month, multicenter, prospective, observational study involving 1701 patients with stable CAD.
- Patients received standard treatments; 50.5% were treated with trimetazidine MR.
- Data collected at inclusion, 1 month, and 3 months.
Main Results:
- Weekly angina episodes decreased from 2.55 to 0.41 (p<0.0001) with trimetazidine prolong 80 mg.
- Significant improvements observed in CCS grading, with a shift towards lower classes.
- Mean blood pressure and heart rate showed modest reductions.
Conclusions:
- Once-daily trimetazidine prolong 80 mg effectively reduces angina frequency and severity in stable CAD patients.
- Benefits may stem from anti-ischemic effects and improved medication adherence.
- Trimetazidine is a valuable addition to managing stable CAD in real-world settings.
Introduction:
The effectiveness of the manegement of stable coronary artery disease among outpatients is not well known.
Aim:
The aim of the study was to evaluate the effect of daily once trimetazidine prolong 80 mg on the angina number and severity (Canadian Cardiovascular Society class).
Method:
This multicenter, prospective, observational, 3-month clinical study included 2160 patients, but only 1701 patients completed the study. The patients' mean age was 68 years (17% under 60 years). The start of angina was 7.8 ± 6.7 years. Hypertension (93.4%) and hypercholesterolemia (81%) were very common.
Results:
The patients were well treated with beta-blocking agents (88%), calcium antagonists (49%), angiotensin-converting enzym inhibitors (90%) and statin (77%) but only 5% received ivabradine and 50.5% was treated with trimetazidine MR. The patients attended 3 visits (inclusion, 1 month, 3 month). During the 3-month period, the weekly angina number of all patients treated with trimetazidine prolong 80 mg decreased from 2.55 to 0.41 (p<0.0001). A favorable effect was observed in CCS grading: CCS I. from 40.37% to 66.81%, CCS II. from 49.89% to 30.59%, CCS III. from 9.17% to 2% and CCS IV. from 0.56% to 0%. The mean office measured blood pressure decreased from 137/83 mmHg to 130/80 mmHg and the heart rate from 74 bpm to 71 bpm.
Conclusions:
In the real-life, in the stable coronary artery disease the angina remains despite the medical treatment. Once a day administered trimetazidine prolong 80 mg significantly reduced the weekly number of angina and the severity, too. These beneficial effects mediated not only by antiischemic effect but also by increased medication adherence. Orv Hetil. 2018; 159(38): 1549-1555.
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