Ischemic heart disease: metabolic approaches to management.
The number of patients with coronary artery disease and its risk factors is increasing in Western nations. New treatments for these patients may soon include a class of agents known as the metabolic modulators. This group of agents consists of the partial fatty acid oxidation inhibitors trimetazidine and ranolazine, as well as dichloroacetate, which promotes carbohydrate utilization. Metabolic modulators also include the nutriceuticals L-carnitine and D-ribose. The available evidence regarding the benefits of each of these five agents is reviewed.
Pauly
Daniel F
DF
University of Florida College of Medicine, Division of Cardiovascular Medicine, Gainesville, Florida 32610, USA. paulydf@medicine.ufl.edu
Pepine
Carl J
CJ
D000083:Acetanilides; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D002331:Carnitine / Q000627:therapeutic use; D003999:Dichloroacetic Acid / Q000627:therapeutic use; D004734:Energy Metabolism; D006801:Humans; D017202:Myocardial Ischemia / Q000188:drug therapy* / Q000378:metabolism; D010084:Oxidation-Reduction / Q000187:drug effects; D010879:Piperazines / Q000627:therapeutic use; D000069458:Ranolazine; D012266:Ribose / Q000627:therapeutic use; D014292:Trimetazidine / Q000627:therapeutic use
D000083:Acetanilides; D002317:Cardiovascular Agents; D010879:Piperazines; D012266:Ribose; D003999:Dichloroacetic Acid; D000069458:Ranolazine; D014292:Trimetazidine; D002331:Carnitine