Effect of trimetazidine on quality of life in elderly patients with ischemic dilated cardiomyopathy.
BACKGROUND
Elderly patients have an increased incidence of ischemic dilated cardiomyopathy, often related to diffuse coronary artery disease. Data have been cumulated to suggest that trimetazidine improves myocardial ischemia in patients with ischemic heart disease and improves left ventricular function in elderly patients with ischemic cardiomyopathy. The purpose of the present study was to assess the effects of trimetazidine in addition to standard cardiovascular therapy on left ventricular function and quality of life (QOL) parameters in elderly patients with ischemic heart disease and reduced left ventricular function.


METHODS
Patients were randomized to receive either trimetazidine (twice daily) or placebo (twice daily) in addition to standard therapy, and were evaluated at baseline and after 6 months.


RESULTS
Forty-seven patients completed the study (40 male, seven female; mean [+/-SD] age 78+/-3.4 years). Demographic data were comparable between the two groups with respect to sex, age, and race. At 6 months there was a significant improvement in the number of angina episodes per week in the trimetazidine group (-2.3+/-1, P=0.023). The overall assessment of QOL by a visual analog scale showed an improvement in patients randomized to trimetazidine at 6 months (from 4.1+/-0.6 to 6.4+/-0.8, P<0.01) and no changes in patients randomized to placebo (from 4.3+/-0.7 to 4.2+/-0.9, P>0.05). Physical QOL, evaluated by a MacNew Quality of Life After Myocardial Infarction questionnaire (MacNewQLMI), improved in patients randomized to trimetazidine but not in those allocated to placebo (32%+/-5% vs. -1%+/-3%, P<0.01). Similar results were obtained on social QOL evaluated by MacNewQLMI with trimetazidine compared with placebo (39%+/-4% vs. -2%+/-5%, P<0.01).


CONCLUSIONS
In elderly patients with ischemic heart disease and reduced ventricular function, trimetazidine improves clinical condition and QOL.
Marazzi
Giuseppe
G
Department of Medical Sciences, Center for Clinical and Basic Research, IRCCS San Raffaele, Roma, Italy. giuseppe.marazzi@sanraffaele.it
Gebara
Otavio
O
Vitale
Cristiana
C
Caminiti
Giuseppe
G
Wajngarten
Mauricio
M
Volterrani
Maurizio
M
Ramires
José A F
JA
Rosano
Giuseppe
G
Fini
Massimo
M
D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology*; D003327:Coronary Disease / Q000150:complications; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017202:Myocardial Ischemia / Q000150:complications*; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014292:Trimetazidine / Q000494:pharmacology / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000494:pharmacology / Q000627:therapeutic use*; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000517:prevention & control
D014665:Vasodilator Agents; D014292:Trimetazidine