title: The efficacy of trimetazidine on stable angina pectoris: a meta-analysis of randomized clinical trials.
abstract: This meta-analysis aimed to evaluate the efficacy of trimetazidine in combination with other anti-anginal drugs versus other anti-anginal drugs in the treatment of stable angina pectoris (SAP). Randomized controlled trials (RCTs) published in English and Chinese were retrieved from computerized databases: Embase, PubMed, and CNKI. Primary outcomes consist of clinical parameters (numbers of weekly angina attacks and nitroglycerin use) and ergometric parameters (time to 1mm ST-segment depression, and total work (in Mets) and exercise duration (in seconds) at peak exercise) in stable angina pectoris treated by trimetazidine or not. The quality of studies was evaluated using Jadad score. Data analysis of 13 studies was performed using Stata 12.0 software. Results showed that treatment of trimetazidine and other anti-anginal drugs was associated with a smaller weekly mean number of angina attacks (WMD=-0.95, 95%CI: -1.30 to -0.61, Z=5.39, P<0.001), fewer weekly nitroglycerin use (WMD=-0.98, 95%CI: -1.44 to -0.52, Z=4.19, P<0.001), longer time to 1mm ST-segment depression (WMD=0.30, 95%CI: 0.17 to 0.43, Z=4.46, P<0.001), higher total work (WMD=0.82, 95%CI: 0.44 to 1.20, Z=4.22, P<0.001) and longer exercise duration at peak exercise (WMD=49.81, 95%CI: 15.04 to 84.57, Z=6.38, P<0.001) than treatment of other anti-anginal drugs for stable angina pectoris. Sensitivity analysis was performed. Sub-group analysis showed that treatment duration was not a significant moderator and patients treated within 8 weeks and above 12 weeks had no difference in the outcomes addressed in this meta-analysis. No publish bias was detected. This meta-analysis confirms the efficacy of trimetazidine in the treatment of stable angina pectoris, in comparison with conventional antianginal agents, regardless of treatment duration.
authors.affiliation: Department of Cardiology, Zhongnan hospital of Wuhan university, No. 169 Donghu Road, Wuhan 430071, Hubei, China.
authors.forename: Song
authors.initials: S
authors.lastname: Peng
authors.affiliation: Institute of virology, Wuhan University School of Medicine, Wuhan 430072, Hubei, China.
authors.forename: Min
authors.initials: M
authors.lastname: Zhao
authors.affiliation: Department of Cardiology, Zhongnan hospital of Wuhan university, No. 169 Donghu Road, Wuhan 430071, Hubei, China. Electronic address: wanjing320@aliyun.com.
authors.forename: Jing
authors.initials: J
authors.lastname: Wan
authors.affiliation: Department of Cardiology, Zhongnan hospital of Wuhan university, No. 169 Donghu Road, Wuhan 430071, Hubei, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Fang
authors.affiliation: Department of Cardiology, Zhongnan hospital of Wuhan university, No. 169 Donghu Road, Wuhan 430071, Hubei, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Fang
authors.affiliation: Department of Cardiology, Zhongnan hospital of Wuhan university, No. 169 Donghu Road, Wuhan 430071, Hubei, China.
authors.forename: Kaiyong
authors.initials: K
authors.lastname: Li
mesh_terms: D000787:Angina Pectoris / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D016032:Randomized Controlled Trials as Topic / Q000379:methods; D016896:Treatment Outcome; D014292:Trimetazidine / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D014665:Vasodilator Agents; D014292:Trimetazidine
keywords: Antianginal agents; Meta-analysis; Randomized controlled trials; Stable angina pectoris; Trimetazidine