Treatment of stable angina with low dose diltiazem in combination with the metabolic agent trimetazidine

Manchanda, S. C.

doi:10.1016/s0167-5273(02)00367-4

Cited by 11 publications

(7 citation statements)

References 17 publications

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“…The TRIMetazidine in POLand (TRIMPOL)-II study [15], which was the continuation of the TRIMPOL-I study [16], the study by Sellier and Broustet [17] and the most recent—the VASCO (Efficacy of trimetazidine on functional capacity in symptomatic patients with stable exertional angina) study [18]—were the studies providing evidence generated in support of trimetazidine as an add-on to beta-blockers in symptomatic patients with angina pectoris. Two other studies by Manchanda and Krishnaswami [19, 20] and Manchanda [19, 20] supported the efficacy of trimetazidine as an additional therapy to calcium channel blockers.…”

Section: Trimetazidine In Stable Coronary Artery Diseasementioning

confidence: 88%

“…Similarly to the data presented in the paper by Tuunanen et al [37], Fragasso et al [29] demonstrated, by analysing 16 diabetic patients with ischaemic cardiomyopathy, that the use of trimetazidine 20 mg three times a day led to a significant reduction in fasting blood glucose compared with placebo after a 6- and 12-month follow-up (121 ± 30 vs 136 ± 40 mg/dL, respectively; p = 0.02 and 125 ± 36 mg/dL vs 140 ± 43 mg/dL; p = 0.19) with a simultaneous reduction in insulin resistance [20]. However, these results have not been confirmed in all available papers.…”

Section: Trimetazidine In Chronic Heart Failurementioning

confidence: 99%

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Defining the Role of Trimetazidine in the Treatment of Cardiovascular Disorders: Some Insights on Its Role in Heart Failure and Peripheral Artery Disease

Chruściel

Rysz

Banach

2014

Drugs

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Trimetazidine is a cytoprotective drug whose cardiovascular effectiveness, especially in patients with stable ischemic heart disease, has been the source of much controversy in recent years; some have gone so far as to treat the medication as a ‘placebo drug’ whose new side effects, such as Parkinsonian symptoms, outweigh its benefits. This article is an attempt to present the recent key studies, including meta-analyses, on the use of trimetazidine in chronic heart failure, also in patients with diabetes mellitus and arrhythmia, as well as in peripheral artery disease. This paper also includes the most recent European Society of Cardiology guidelines, including those of 2013, on the use of trimetazidine in cardiovascular disease.

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Section: Trimetazidine In Stable Coronary Artery Diseasementioning

confidence: 88%

Section: Trimetazidine In Chronic Heart Failurementioning

confidence: 99%

Defining the Role of Trimetazidine in the Treatment of Cardiovascular Disorders: Some Insights on Its Role in Heart Failure and Peripheral Artery Disease

Chruściel

Rysz

Banach

2014

Drugs

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“…Trimetazidine plus diltiazem demonstrated significant improvement in patients with stable angina pectoris compared to diltiazem plus placebo 20, 21. Similarly, trimetazidine in combination with standard therapies, improved LV function in diabetic patients with CAD and caused a significant reduction in mortality after surviving a myocardial infarction 22 .…”

Section: Metabolic Management Of Cad and Hfmentioning

confidence: 99%

Modulation of myocardial energetics: An important category of agents in the multimodal treatment of coronary artery disease and heart failure

Dalal

Mishra

2017

Indian Heart Journal

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The combined and relative contribution of glucose and fatty acid oxidation generates myocardial energy, which regulates the cardiac function and efficiency. Any dysregulation in this metabolic homeostasis can adversely affect the function of heart and contribute to cardiac conditions such as angina and heart failure. Metabolic agents ameliorate this internal metabolic anomaly, by shifting the energy production pathway from free fatty acids to glucose, resulting in a better performance of the heart. Metabolic therapy is relatively a new modality, which functions through optimization of cardiac substrate metabolism. Among the metabolic therapies, trimetazidine and ranolazine are the agents presently available in India. In the present review, we would like to present the metabolic perspective of pathophysiology of coronary artery disease and heart failure, and metabolic therapy by using trimetazidine and ranolazine.

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“…Studies have demonstrated trimetazidine is effective as monotherapy, has equivalent antianginal efficacy with existing agents, and is an effective agent for combination therapy. 70 Ivabradine is a novel antianginal agent that lowers heart rate through specific inhibition of the pacemaker I f current in the sinoatrial node cells. Because of a highly specific mechanism of action, however, the drug does not significantly affect myocardial contractility or blood pressure.…”

Section: Drug Therapymentioning

confidence: 99%

Traditional Management of Chronic Stable Angina

Trujillo

Dobesh

2007

Pharmacotherapy

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The clinical syndrome of chronic stable angina is an age-related condition that is one common manifestation of coronary artery disease (CAD). The presence of angina significantly affects quality of life when patients must limit their activities of daily living in an effort to prevent the occurrence of anginal attacks. In addition, patients are at risk for significant complications of CAD such as myocardial infarction, heart failure, stroke, and death. Therefore, treatment should focus not only on relief of symptoms and improvements in quality of life, but also on preventing disease progression and reducing the risk of complications from CAD. All patients should be instructed on the appropriate use of sublingual nitroglycerin for the immediate treatment of anginal episodes. Beta-blockers, calcium channel blockers, long-acting nitrate therapy, and ranolazine can prevent anginal symptoms. In addition, aggressive risk factor management, healthy lifestyle changes, antiplatelet agents such as aspirin, and angiotensin-converting enzyme inhibitors all should be used to prevent disease progression and occurrence of myocardial infarction or death. Many patients will be candidates for revascularization of the myocardium with either percutaneous coronary intervention or coronary artery bypass grafting for relief of symptoms as well as improvement in prognosis. Even after revascularization, patients may still require antianginal drug therapy. All patients undergoing revascularization should be guided to make appropriate lifestyle changes and to make concerted efforts to manage risk factors for CAD.

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Treatment of stable angina with low dose diltiazem in combination with the metabolic agent trimetazidine

Cited by 11 publications

References 17 publications

Defining the Role of Trimetazidine in the Treatment of Cardiovascular Disorders: Some Insights on Its Role in Heart Failure and Peripheral Artery Disease

Defining the Role of Trimetazidine in the Treatment of Cardiovascular Disorders: Some Insights on Its Role in Heart Failure and Peripheral Artery Disease

Modulation of myocardial energetics: An important category of agents in the multimodal treatment of coronary artery disease and heart failure

Traditional Management of Chronic Stable Angina

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