Related Experiment Videos
The Effect of Trimetazidine in the Treatment of Microvascular Angina
Nalbantgil1, Altintiğ, Yilmaz
1Ege University Medical School, Cardiology Department, Izmir, Turkey
Abstract:
Although the pathophysiology of microvascular angina is unclear, intracellular metabolic changes are believed to be the main factors. Trimetazidine has an intracellular metabolic effect in coronary insufficiency. The effect of trimetazidine in microvascular angina is unknown. Thirty-five patients (8 men, 27 women, age 36-57 years, mean 43.9 +/- 6.4 years) with microvascular angina were included in this study. The effects of trimetazidine (60 mg daily) were investigated in a placebo-controlled, double-blind study consisting of two 4-week treatment periods. Patients were assessed by symptom-limited exercise testing (Bruce protocol). Heart rate and systolic blood pressure at rest, peak exercise, and the time of 1 mm ST segment depression were not significantly different between placebo and trimetazidine treatment. Trimetazidine prolonged total exercise time and time to 1 mm ST depression compared with placebo. Maximum ST depression was less in patients with trimetazidine therapy than those with placebo. It is concluded that trimetazidine has a beneficial effect in cases with microvascular angina.
Insights
Trimetazidine shows promise for treating microvascular angina by improving exercise tolerance and reducing ST depression. This study found beneficial effects in patients with this condition.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Microvascular angina pathophysiology is not fully understood, but intracellular metabolic changes are implicated.
- Trimetazidine is known to affect intracellular metabolism in coronary insufficiency.
- The efficacy of trimetazidine in microvascular angina remains to be determined.
Purpose of the Study:
- To evaluate the effects of trimetazidine in patients diagnosed with microvascular angina.
- To compare trimetazidine's efficacy against a placebo in a double-blind study.
Main Methods:
- A placebo-controlled, double-blind study was conducted over two 4-week periods.
- Thirty-five patients with microvascular angina received either trimetazidine (60 mg daily) or a placebo.
- Symptom-limited exercise testing (Bruce protocol) was used for patient assessment.
Main Results:
- Trimetazidine significantly prolonged total exercise time and the time to 1 mm ST segment depression compared to placebo.
- Maximum ST depression was reduced in the trimetazidine group.
- No significant differences were observed in heart rate or systolic blood pressure between groups.
Conclusions:
- Trimetazidine demonstrates a beneficial effect in managing microvascular angina.
- The drug improves exercise capacity and reduces ischemic indicators in these patients.