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Anti-anginal and anti-ischemic effectiveness of trimetazidine MB in patients with unstable angina

Abstract

Aim. То analyse trimetazidine therapy potential in unstable angina (UA).

Material and methods. In a randomised, placebo-controlled study including 50 UA patients, the effects of adding trimetazidine MB to standard therapy on angina attack dynamics, total ST depression and QT duration were evaluated. Clinical outcomes were registered during 6 months of the follow-up.

Results. In trimetazidine patients (main group, MG), angina attack number reduced after 7 days of the treatment, as well as 30 days and 6 months later — 2,70±1,06, 0,50±0,09 and 0,7±0,12 per week, respectively, comparing to the control group (CG) receiving standard therapy only — 7,10±0,95 (p<0,05); 5,30±1,14 (p<0,01) and 2,0±0,14 (p<0,01), respectively. Faster reduction in total ST depression was observed in MG: 2 hours later, 1,14±0,2 mm in MG vs. 2,60±0,3 mm in CG; at Day 3, 1,11±0,2 mm vs. 2,09±0,3 mm, respectively; at Day 7, 1,09±0,1 mm vs. 2,03±0,1, respectively; one month later, 0,76±0,1 mm vs. 1,95±0,1 mm (p<0,01). QT duration reduced among MG patients faster than in CG individuals, especially among those with initially increased QT interval. The number of cardiovascular outcomes (myocardial infarction, death, repeated hospitalisation, revascularisation) in 6 months was 8 in MG and 25 in CG (Fishers p=0,0016).

Conclusion. The complex UA therapy should include an anti-ischemic medication trimetazidine MB.

About the Authors

M. G. Glezer
I.M. Sechenov Moscow Medical Academy
Russian Federation

Urgent and Preventive Cardiology Department, Moscow City Clinical Hospital No. 59



S. V. Msilyev
I.M. Sechenov Moscow Medical Academy
Russian Federation

Urgent and Preventive Cardiology Department, Moscow City Clinical Hospital No. 59



References

1. Grynberg A. Effectors of fatty acid oxidation reduction: promising new anti-ischaemic agents. Curr Pharm Des 2005; 11(4): 489-509.

2. Lopaschuk GD. Pharmacologic rationale for trimetazidine in the treatment of ischemic heart disease. Am J Cardiovasc Drugs 2003; 3(Suppl.l): 21-6.

3. Kant or PF, Lucien A, Kozak R, Lopaschuk GD. The antianginal drug trimetazidine shifts cardiac energy metabolism from fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase. Circ Res 2000; 86: 580—8.

4. Stanley WC, Marzilli M. Metabolic therapy in the treatment of ischaemic heart disease: the pharmacology of trimetazidine. Fimdam & Clin Pharmac 2003; 17(2): 133—45.

5. Sentex E, Sergiel JP, Lucien A, Grynberg A. Trimetazidine increases phospholipid turnover in ventricular myocyte. Mol Cell Bioch 1997; 175: 153-62.

6. Marzilli M. Cardioprotective effects of trimetazidine: a review. Curr Med Res Opin 2003; 19(7): 661-72.

7. Cochrane Database of Systematic Reviews 2005, Issue 4. Art. No.: CD003614. DOI; 10.1002/14651858,CD003614.pub2.

8. Kountouris E, Pappa E, Pappas K, et al. Metabolic management of coronary heart disease: adjunctive treatment with trimetazidine decreases QT dispersion in patients with a first acute myocardial infarction. Cardiovasc Drugs Ther 2001; 15(4): 315—21.

9. Ulgen MS, Akdemir O, Toprak N. The effects of trimetazidine on heart rate variability and signal-averaged electrocardiography in early period of acute myocardial infarction. Int J Cardiol 2001; 77(2-3): 255-62.

10. Die зер M 4 ., Васильев С. В., Вепшиков R В. Ре зультаты лечения нестабильной стенокардии предукталом. Здравоохр мед тех 2006; 1(25): 27.

11. Шилов А.М., Мельник М.В., Санбдзе И.Д. Диагностика, профилактика й Лечение синдрома удлинения QT интервала. Методические рекомендации. Москва 2001; 28 с.

12. Ziegler D, Zentai CP, Perz S, et al, KORA Study Group Prediction of mortality using measures of cardiac autonomic dysfunction in the diabetic and nondiabetic population: the MONICA/KORA Augsburg Cohort Study. Diabetes Care 2008; 31(3): 556-61.

13. Padmanabhan S, Silvet H, Amin J, Pai RG. Prognostic Value of QT Interval and QT Dispersion in Patients With Left Ventricular Systolic Dysfunction: Results From a Cohort of 2265 Patients With an Ejection Fraction of <40 %, Am Heart J 2003; 145(1): 132-8.


Review

For citations:


Glezer M.G., Msilyev S.V. Anti-anginal and anti-ischemic effectiveness of trimetazidine MB in patients with unstable angina. Cardiovascular Therapy and Prevention. 2009;8(1):42-46. (In Russ.)

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ISSN 1728-8800 (Print)
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