title: Evaluation of trimetazidine in angina pectoris by echocardiography and radionuclide angiography: a meta-analysis of randomized, controlled trials.
abstract: BACKGROUND
  The objective of this meta-analysis was to evaluate the efficacy of the metabolic agent trimetazidine (TMZ) as monotherapy in the treatment of stable angina pectoris, from echocardiography and radionuclide angiography data.
  
  
  OBJECTIVE
  Treatment with TMZ proved to be as effective as other first-line antianginal agents for coronary patients, and it provided additional efficacy in combination with hemodynamic agents.
  
  
  METHODS
  A search of the literature published between 1965 and 2008 was performed on the MEDLINE and EMBASE databases. Only randomized, controlled trials were included in this meta-analysis. Patients had to be treated for at least 2 weeks with data on the following 4 parameters at baseline and at the end of the treatment period: left ventricular ejection fraction (LVEF), LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), and wall motion score index (WMSI). The quality of the trials was assessed by the Jadad score.
  
  
  RESULTS
  Eleven clinical studies meeting our criteria were analyzed. Results showed that TMZ significantly improved LVEF, with a mean increase of 6.88% (95% confidence interval [CI]: 5.50-8.25), and significantly reduced LVESV by 11.58 mL (95% CI: 5.79-17.37) and WMSI by 0.23 (95% CI: 0.07-0.38). Changes in LVEDV were variable. In both the long term and the short term, TMZ can improve LV function. The efficacy was unchanged in patients with diabetes mellitus.
  
  
  CONCLUSIONS
  This meta-analysis confirmed the efficacy of TMZ monotherapy in improving LV function compared with placebo.
authors.affiliation: Cardiovascular Institute and Fuwai Hospital, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, China.
authors.forename: Bo
authors.initials: B
authors.lastname: Hu
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.forename: Tao
authors.initials: T
authors.lastname: Xu
authors.forename: Tao
authors.initials: T
authors.lastname: Chen
authors.forename: Jin
authors.initials: J
authors.lastname: Guo
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D004359:Drug Therapy, Combination; D004452:Echocardiography; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011875:Radionuclide Angiography; D016032:Randomized Controlled Trials as Topic; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome; D014292:Trimetazidine / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*; D016277:Ventricular Function, Left / Q000187:drug effects
chemical_list: D014665:Vasodilator Agents; D014292:Trimetazidine