[Clinical aspects of trimetazidine (preductal) administration as an antianginal drug].
OBJECTIVE
To study antianginal effectiveness of trimetazidine (TMS) in monotherapy and combined antianginal therapy; to design approaches to prediction of its effect.


METHODS
An open cross-over randomised trial enrolled 29 anginal patients. They were given a single TMS dose (60 mg) and its effect was compared to that of placebo, propranolol, verapamil, isosorbide dinitrate, nifedipine). The effect was estimated by an increment of bicycle exercise (BE) duration necessary to depress ST segment by 1 mm. 10 patients retained signs of myocardial ischemia at BE though they were treated with specially selected antianginal drugs. In them, we assessed additional benefit of adjuvant TMS. The drugs were tried under acute test and one-month treatment.


RESULTS
In acute test a significant antianginal effects of TMS were registered against the placebo. Differences in efficiency of the antianginal drugs were insignificant. The addition of TMS to the selected drugs gave rise to the trend to prolongation of time to ST segment depression by 1 mm. We found a strong correlation between TMS efficiency in acute pharmacological test and in long-term administration. This enables using BE for prediction of long-term effect of the drug.


CONCLUSIONS
TMS has a significant antianginal effect. It is especially beneficial in cases of insufficient effectiveness of conventional antianginal drugs or when their use is problematic because of marked disturbances of hemodynamics.
Zhiliaev
E V
EV
Urzhumova
T V
TV
Glazunov
A V
AV
Sorokoletov
S M
SM
Dzhanashiia
P Kh
PKh
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D018592:Cross-Over Studies; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects; D005080:Exercise Test; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage; D011379:Prognosis; D011433:Propranolol / Q000008:administration & dosage; D014292:Trimetazidine / Q000008:administration & dosage*; D014665:Vasodilator Agents / Q000008:administration & dosage*; D014700:Verapamil / Q000008:administration & dosage
D014665:Vasodilator Agents; D011433:Propranolol; D014700:Verapamil; D009543:Nifedipine; D007548:Isosorbide Dinitrate; D014292:Trimetazidine