Efficacy of trimetazidine – an inhibitor of free fatty acids oxidation in the treatment of patients with stable angina pectoris and heart failure

Abstract

Aim To evaluate efficacy of modified-release trimetazidine (TMZ) included into the standard therapy for patients with stable angina and chronic heart failure (CHF) as a part of a subgroup analysis in the PERSPECTIVE study.Material and methods The study included 806 patients: group 1 (n=691), patients receiving a standard therapy and modified-release TMZ (TMZ group); and group 2 (n=115), patients receiving a standard therapy (control group). Total duration of the study was 12 months.Results In the TMZ group, the weekly number of angina attacks decreased by 41.9% (p<0.0001) in 2 months and by 69.6 % (from baseline, р<0.0001) in 12 months, and the frequency of nitroglycerine dosing decreased by 40.8 % (р<0.0001) and 67.7 % (р<0.0001), respectively. In the control group, the respective values did not change. In the TMZ group compared to the control group, the QT interval was shorter (7.9 %; р<0.05), the left ventricular (LV) end-systolic dimension was reduced (13.4 %; р<0.01), interventricular septal thickness and LV posterior wall thickness were decreased (9.5 %; р<0.01 and 12.2 %; р<0.01, respectively), and the ejection fraction was increased (11.4; р<0.05). Following the TMZ treatment, the leukocyte count in peripheral blood was decreased (5.3 %; р<0.01) and the serum concentration of high-sensitivity C-reactive protein was decreased (30.7 %; р<0.01) vs. increases of these indexes in the control group (17.9 %; р<0.05 and 17.8 %; р<0.05, respectively). The proportion of patients hospitalized for exacerbation of CHF or angina for 12 months was 8.6 % in the TMZ group and 15.7 % in the control group (p=0,001).Conclusion In patients with stable angina and CHF, inclusion of modified-release TMZ into the standard therapy decreases the number of angina attacks, reduces the activity of inflammatory factors, and improves the course of disease.

Effects of trimetazidine on heart failure with reduced ejection fraction and associated clinical outcomes: a systematic review and meta-analysis

“…Six studies (21%) were conducted in Russia and not reported in English. [23][24][25][26][27][28] Only two studies were conducted after the latest major revision of the European Society of Cardiology (ESC) HF guidelines in 2021, which explains the limited HF-background therapy (table 1, online supplemental table A3).…”

Comparing the efficacy and safety of medications in adults with hypertrophic cardiomyopathy: a systematic review and network meta-analysis

“…In an RCT study, no nonsustained ventricular tachycardia was observed in the mavacamten treatment group, but no data about the incidence of TdP was reported ( 35 ). Trimetazidine has been shown to shorten QT intervals in research ( 36 ). As a result, TdP is unlikely to occur.…”

Role of Trimetazidine in Ameliorating Endothelial Dysfunction: A Review

“…Trimetazidine ( Figure 1 ), traditionally used in the management of angina pectoris [ 7 ], is renowned for its efficacy as an anti-ischemic agent [ 8 ]. Recently, it has garnered attention for its potential therapeutic use beyond its primary indication.…”