Antianginal effects of trimetazidine and left ventricular function improvement in patients with stable angina pectoris.
OBJECTIVE
To evaluate the effects of add-on treatment with trimetazidine, single dose and long-term, on clinical and objective parameters of ischemia in patients with stable angina pectoris receiving standard antianginal therapy.


METHODS
One-month single-blind, placebo-controlled study.


METHODS
40 patients with stable angina pectoris.


METHODS
Patients received 1-month treatment with either trimetazidine 20 mg (n = 20) or placebo (n = 20) 3 times daily in addition to standard antianginal therapy.


METHODS
All patients underwent bicycle stress tests at baseline and at 1 month to assess exercise tolerance. Patients receiving trimetazidine also underwent a stress test 2 hours after administration of a 60 mg single dose. Influence of trimetazidine on stress-induced left ventricular function was assessed in 11 patients, with dobutamine stress echocardiography performed at baseline and at 1 month. Clinical efficacy was evaluated in terms of mean weekly number of anginal episodes and weekly nitroglycerin (glyceryl trinitrate) tablet consumption during the study.


RESULTS
Trimetazidine significantly improved most stress test parameters, after a single dose and after 1 month of treatment; the rate-pressure product remained unchanged. Dobutamine tests showed significant (p < 0.05) increases from baseline values in time to onset of anginal pain and threshold dobutamine dose (13.5 +/- 0.7 versus 10.2 +/- 0.8 min, and 43.6 +/- 2.8 versus 35.4 +/- 3.4 microg/kg/min, respectively). The severity of anginal pain and mean weekly number of anginal episodes was reduced significantly (p < 0.05) from baseline values after 1 months' treatment with trimetazidine (1.3 +/- 0.6 versus 2.3 +/- 0.3, and 6.6 +/- 1.4 versus 10.1 +/- 1.3, respectively). After 1 month, weekly consumption of nitroglycerin tablets was decreased by 3.1 from baseline values in the trimetazidine group but increased by 0.3 in the placebo-treated group. No patient withdrew due to treatment-related adverse effects.


CONCLUSIONS
This study confirms the antianginal and anti-ischemic efficacy of single dose and long-term treatment with trimetazidine. Treatment with trimetazidine was well tolerated.
Shlyakhto
Evgeniy V
EV
Department of Internal Medicine, Institute of Cardiovascular Disease of State Medical University-Pavlov Academy, St. Petersburg, Russia.
Almazov
Vladimir V A
VV
Nifontov
Evgeniy M
EM
Vakhrameyeva
Irina V
IV
Rudomanov
Oleg G
OG
Zakharov
Dmitriy V
DV
Kazarin
Vyachesla V
VV
Vakhrameyeva
Natalya V
NV
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D002908:Chronic Disease; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005080:Exercise Test / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009566:Nitrates / Q000627:therapeutic use; D016896:Treatment Outcome; D014292:Trimetazidine / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000187:drug effects*
D000319:Adrenergic beta-Antagonists; D009566:Nitrates; D014665:Vasodilator Agents; D014292:Trimetazidine