title: Influence of trimetazidine and ranolazine on endothelial function in patients with ischemic heart disease.
abstract: OBJECTIVE
  Endothelial dysfunction is an independent predictor of atherosclerosis progression and cardiovascular events in patients with ischemic heart disease. Ranolazine and trimetazidine are novel drugs that reduce angina symptoms in the above-mentioned patients. The aim of this study was to compare the effects of ranolazine and trimetazidine on flow-mediated (FMD) and nitroglycerine-induced (GTN) dilation of the brachial artery.
  
  
  METHODS
  In a prospective, double-blind study, 56 men between 32 and 65 years of age with chronic ischemic heart disease were randomized and subjected to 12 weeks of treatment with either trimetazidine (35 mg twice daily) or ranolazine. Ranolazine was administered at a dose of 375 mg twice daily for 4 weeks and was increased to 500 mg twice daily for the rest of the study. FMD and GTN were measured using high-resolution ultrasound before and after treatment.
  
  
  RESULTS
  FMD increased from 3.5±7.4 to 13.8±9.4% (P<0.013; 294%) in the trimetazidine group and from 2.4±4.3 to 9.5±7.7% (P<0.037; 296%) in the ranolazine group, with no difference between the groups (P=0.444). GTN increased from 16.1±9.2 to 21.2±19.3% (P<0.022; 32%) in the trimetazidine group and from 13.8±9.6 to 21.7±13.7% (P<0.006; 57%) in the ranolazine group, with no difference between the groups (P=0.309).
  
  
  CONCLUSIONS
  Both trimetazidine and ranolazine led to an improvement in FMD and GTN of the brachial artery in patients with ischemic heart disease, with no statistically significant difference between the groups.
authors.affiliation: Departments of aCardiology bAngiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.
authors.forename: Andreja
authors.initials: A
authors.lastname: Rehberger-Likozar
authors.forename: Miran
authors.initials: M
authors.lastname: Šebeštjen
mesh_terms: D000328:Adult; D000368:Aged; D001783:Blood Flow Velocity; D001916:Brachial Artery / Q000000981:diagnostic imaging / Q000503:physiopathology*; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000000981:diagnostic imaging / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy* / Q000503:physiopathology; D005996:Nitroglycerin; D000069458:Ranolazine / Q000627:therapeutic use*; D026941:Sodium Channel Blockers / Q000627:therapeutic use*; D016896:Treatment Outcome; D014292:Trimetazidine / Q000627:therapeutic use*; D018608:Ultrasonography, Doppler; D014664:Vasodilation; D014665:Vasodilator Agents / Q000627:therapeutic use*
chemical_list: D026941:Sodium Channel Blockers; D014665:Vasodilator Agents; D000069458:Ranolazine; D005996:Nitroglycerin; D014292:Trimetazidine