Trimetazidine Use in Cardiovascular Disease

Area of Science:

• Cardiology
• Pharmacology

Background:

• Trimetazidine is an antianginal drug used for stable coronary artery disease and angina pectoris.
• Its mechanism involves inhibiting fatty acid beta-oxidation, with antioxidant and anti-fibrosis properties.

Purpose of the Study:

• To review the current evidence and guidelines regarding trimetazidine's role in cardiovascular disease treatment.
• To assess its efficacy beyond stable angina, particularly in heart failure and coronary interventions.

Main Methods:

• Review of European guidelines and existing studies on trimetazidine.
• Analysis of its use as a second-line antianginal agent and add-on therapy.
• Evaluation of its potential benefits in heart failure with reduced ejection fraction and post-coronary intervention.

Main Results:

• European guidelines classify trimetazidine as a second-line agent for stable angina.
• It has a Class IIb recommendation for heart failure with reduced ejection fraction and angina due to improved ventricular function and symptom relief.
• Studies suggest benefits in reducing anginal attacks and myocardial damage during coronary interventions, but require further validation.

Conclusions:

• Trimetazidine is an established second-line treatment for stable angina.
• Its role in heart failure is promising but requires larger trials to confirm mortality benefits.
• Further research is needed to establish its definitive role in guideline-directed therapy for coronary interventions.