title: Additional use of trimetazidine in patients with chronic heart failure: a meta-analysis.
abstract: OBJECTIVE
  The aim of this meta-analysis was to evaluate the effects of additional trimetazidine (TMZ) treatment on patients with chronic heart failure (CHF).
  
  
  BACKGROUND
  Conflicting results currently exist on the clinical use of TMZ in CHF patients.
  
  
  METHODS
  PubMed, MEDLINE, EMBASE, and EBM Reviews databases were searched through November 2010 for randomized controlled trials (RCTs) assessing TMZ treatment in CHF patients. Data concerning the study design, patient characteristics, and outcomes were extracted. Risk ratio (RR) and weighted mean differences (WMD) were calculated using fixed or random effects models.
  
  
  RESULTS
  Sixteen RCTs involving 884 CHF patients were included. Hospitalization for cardiac causes (RR: 0.43, p = 0.03), but not all-cause mortality (RR: 0.47, p = 0.27), was reduced by TMZ treatment. Moreover, TMZ therapy was associated not only with the increase of left ventricular ejection fraction (WMD: 6.46%, p < 0.0001) and total exercise time (WMD: 63.75 seconds, p < 0.0001), but also with the decrease of New York Heart Association functional class (WMD: -0.57, p = 0.0003), left ventricular end-systolic diameter (WMD: -6.67 mm, p < 0.0001), left ventricular end-diastolic diameter (WMD: -6.05 mm, p < 0.0001), and B-type natriuretic peptide (WMD: -203.40 pg/ml, p = 0.0002).
  
  
  CONCLUSIONS
  Additional use of TMZ in CHF patients may decrease hospitalization for cardiac causes, improve clinical symptoms and cardiac function, and simultaneously ameliorate left ventricular remodeling.
authors.affiliation: Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital of Fudan University, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.forename: Yizhou
authors.initials: Y
authors.lastname: Lu
authors.forename: Hong
authors.initials: H
authors.lastname: Jiang
authors.forename: Liming
authors.initials: L
authors.lastname: Zhang
authors.forename: Aijun
authors.initials: A
authors.lastname: Sun
authors.forename: Yunzeng
authors.initials: Y
authors.lastname: Zou
authors.forename: Junbo
authors.initials: J
authors.lastname: Ge
mesh_terms: D018450:Disease Progression; D006333:Heart Failure / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D011379:Prognosis; D014292:Trimetazidine / Q000008:administration & dosage / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D020257:Ventricular Remodeling / Q000187:drug effects*
chemical_list: D014665:Vasodilator Agents; D014292:Trimetazidine