ROLE OF TRIMETAZIDINE, A CYTOPROTECTIVE AGENT IN ISCHEMIC HEART DISEASE
Abstract
ABSTRACT
Objectives: Metabolic agents such as trimetazidine offer a benefits role of cytoprotection in ischemic heart disease (IHD) through an inhibition of
cardiac fatty acid oxidation and improving myocardial glucose utilization. To show the efficacy of trimetazidine in reducing the incidence of angina
and improving exercise tolerance.
Methods: 50 diagnosed cases of chronic stable angina taking conventional treatment were subjected to stress test (treadmill) on day 0 to evaluate
the parameters such as effort duration and ST-segment changes at the end of the exercise. After evaluation, the patients will be given trimetazidine
for a period of 6-week at a dosage of 60 mg (in three divided doses) daily. After completion of the stipulated period, a second stress test evaluation
was done.
Results: The present study consisted of 50 patients of chronic stable angina, out of which 35 were males and 15 were female patients. It was seen that
trimetazidine intake brought about an increase in the mean exercise time from 7.086±0.96 to 8.3±0.75 and showed good symptomatic improvement
(in 31 patients). 15 patients did not show any appreciable (>1 minute) increase in the effort duration. No severe symptoms were reported to warrant
discontinuation of the drug.
Conclusion: Trimetazidine is an effective anti-anginal as monotherapy as well as an adjuvant to conventional anti-anginals as a cytoprotective agent.
Keywords: Trimetazidine, Cytoprotective, Metabolic modulator, Ischemic heart disease.
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Dyspnea Weakness Palpitation
and dyspnea
Presenting compliant before therapy 15 22 10 1 2
No. of patients showing improvement
after trimetazidine therapy
12 6 1 2
Table 3: ST-segment improvement and increase in exercise
time (after trimetazidine)
Sign and Symptom
improvement
Srinath Reddy K, Shah B, Varghese C, Ramadoss A. Responding to the
threat of chronic diseases in India. Lancet 2005;366(9498):1744-9.
Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of
type 2 diabetes: Indian scenario. Indian J Med Res 2007;125(3):217-30.
Gupta R. Trends in hypertension epidemiology in India. J Hum
Hypertens 2004;18(2):73-8.
Prabhakaran D, Chaturvedi V, Shah P, Manhapra A, Jeemon P, Shah B,
et al. Differences in the prevalence of metabolic syndrome in urban and
rural India: A problem of urbanization. Chronic Illn 2007;3(1):8-19.
Stanley WC, Marzilli M. Metabolic therapy in the treatment of
ischaemic heart disease: The pharmacology of trimetazidine. Fundam
Clin Pharmacol 2003;17(2):133-45.
Lee L, Horowitz J, Frenneaux M. Metabolic manipulation in
ischaemic heart disease, a novel approach to treatment. Eur Heart J
;25(8):634-41.
Increase in exercise time Improvement
in ST-segment
<1 minute >1 minute
No. of patients 16 34 33
Percentage of patients 32 68 66
Banach M. The role of trimetazidine in the treatment of heart diseases.
Poznan: Termedia Publishing House; 2006.
Chrusciel P, Rysz J, Banach M. Defining the role of trimetazidine in the
treatment of cardiovascular disorders: Some insights on its role in heart
failure and peripheral artery disease. Drugs 2014;74(9):971-80.
Asian J Pharm Clin Res, Vol 9, Issue 2, 2016, 298-301
Kaur et al.
Astarie-Dequeker C, Joulin Y, Devynck MA. Inhibitory effect of
trimetazidine on thrombin-induced aggregation and calcium entry into
human platelets. J Cardiovasc Pharmacol 1994;23(3):401-7.
Selzer A, Cohn K. On the interpretation of the exercise test. Circulation
;58(2):193-5.
Detry JM, Sellier P, Pennaforte S, Cokkinos D, Dargie H, Mathes P.
Trimetazidine: A new concept in the treatment of angina. Comparison
with propranolol in patients with stable angina. Trimetazidine
European Multicenter Study Group. Br J Clin Pharmacol
;37(3):279-88.
Sellier P, Broustet JP. Assessment of anti-ischemic and antianginal
effect at trough plasma concentration and safety of trimetazidine
MR 35 mg in patients with stable angina pectoris: A multicenter,
double-blind, placebo-controlled study. Am J Cardiovasc Drugs
;3(5):361-9.
Marzilli M, Klein WW. Efficacy and tolerability of trimetazidine instable
angina: A
meta-analysis
of randomized, double-blind, controlled
trials.
Coron Artery
Dis 2003;14(2):171-9.
Szwed H, Pachocki R, Domzal-Bochenska M, Szymczak K,
Szydlowski Z, Paradowski A, et al. Efficacy and tolerance of
trimetazidine, a metabolic antianginal, in combination with a
hemodynamic antianginal in stable exertion angina. TRIMPOL I, a
multicenter study. Presse Med 2000;29(10):533-8.
Szwed H, Sadowski Z, Elikowski W, Koronkiewicz A, Mamcarz A,
Orszulak W, et al. Combination treatment in stable effort angina using
trimetazidine and metoprolol: Results of a randomized, double-blind,
multicentre study (TRIMPOL II). TRIMetazidine in POLand. Eur Heart
J 2001;22(24):2267-74.
Vitale C, Spoletini I, Malorni W, Perrone-Filardi P, Volterrani M,
Rosano GM. Efficacy of trimetazidine on functional capacity in
symptomatic patients with stable exertional angina – The VASCOangina
study.
Int J Cardiol 2013;168(2):1078-81.
Manchanda SC, Krishnaswami S. Combination treatment
with trimetazidine and diltiazem in-stable angina pectoris.
Heart 1997;78(4):353-7.
Manchanda SC. Treatment of stable angina with low dose diltiazem
in combination with the metabolic agent trimetazidine. Int J Cardiol
;88(1):83-9.
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