[A prospective study on trimetazidine effectiveness and tolerability in diabetic patients in association to the previous treatment of their coronary disease. DIETRIC study].
OBJECTIVE
Diabetics frequently suffer diffuse coronary disease with difficulties for coronary artery bypass graft, which means that they require multiple medical treatment. Trimetazidine is an anti-ischemic agent that improves the myocardial metabolism and that can be especially useful in the ischemic myocardium of diabetic patients. The objective of this study is to evaluate in diabetic patients the anti-ischemic effectiveness of trimetazidine associated with regular medical treatment.


METHODS
In the DIETRIC study 580 patients with diabetes type 2 and coronary disease have been included for the assessment of antianginous effect of trimetazidine (20 mg/8 h). Basal clinical record, physical examination, laboratory evaluation, ECG and exercise test were carried out, with 6-month follow-up. In this article the clinical and exercise test response to the treatment is analyzed.


RESULTS
A reduction of angina episodes was observed (2.8 vs 0,9; p < 0.001), in addition to a reduction of the number of weekly nitroglycerin tablets (2.5 vs 0,7; p < 0.001). In the exercise test carried out at 6-month follow-up an increase in its length was observed (441 vs 391 s; p < 0.001); also an increase of the time up to the decline of ST segment (214 vs 209 s; p = 0.02); at the same time a smaller decline of ST segment occurred (1.7 vs 1,2; p < 0.001). Tolerance was excellent.


CONCLUSIONS
In this group of patients with diabetes mellitus type 2 and coronary artery disease, trimetazidine associated with regular medical treatment decreased the incidence of angina episodes and the ischemic response in the exercise test with an excellent tolerance.
Rodríguez Padial
L
L
Servicio de Cardiología, Hospital Virgen de la Salud, Toledo. lrodriguez@sescam.org
Maicas Bellido
C
C
Velázquez Martín
M
M
Gil Polo
B
B
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000150:complications* / Q000188:drug therapy*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014292:Trimetazidine / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D014292:Trimetazidine