Document Detail

Clinical features of an anti-anginal drug in angina pectoris.
MedLine Citation:
PMID:  7904559     Owner:  NLM     Status:  MEDLINE    
Trimetazidine (TMZ) exerts anti-ischaemic effects without any associated central haemodynamic change, both at rest and with exercise. These findings suggest that TMZ has a direct cytoprotective effect, the efficacy of which has been confirmed by clinical studies in effort angina. TMZ as monotherapy when compared with placebo, in acute (60 mg) as well as in chronic (20 mg t.i.d.) administration, significantly improves exercise tolerance: total work, duration of exercise and time to 1 mm ST segment depression, without changing the rate-pressure product. Moreover, during chronic treatment TMZ decreases the rate of anginal attacks. In patients with coronary heart disease insufficiently controlled with nifedipine or a beta-blocker as monotherapy, the addition of TMZ (20 mg t.i.d.) significantly reduces the number of anginal attacks and improves exercise capacity. TMZ antianginal activity in monotherapy has also been compared in double-blind controlled studies with that of a calcium channel antagonist and a beta-blocker as reference drugs. TMZ is as efficient as nifedipine or propranolol on clinical variables as well as on ergometric criteria, but unlike these two reference drugs, which act through a haemodynamic mechanism, TMZ does not decrease rate-pressure product. Furthermore, in the study comparing TMZ with propranolol, TMZ was shown to decrease ischaemic episodes recorded by ECG ambulatory monitoring. These data show that TMZ belongs to the major antianginal agents available today. However, the absence of central haemodynamic effects suggests that the drug has a novel anti-ischaemic mechanism involving direct myocardial cytoprotection.
J M Detry
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  European heart journal     Volume:  14 Suppl G     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1993 Nov 
Date Detail:
Created Date:  1994-02-24     Completed Date:  1994-02-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  18-24     Citation Subset:  IM    
Département de Médecine Interne, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Bruxelles, Belgium.
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MeSH Terms
Adrenergic beta-Antagonists / therapeutic use
Angina Pectoris / drug therapy*
Calcium Channel Blockers / therapeutic use
Clinical Trials as Topic
Drug Therapy, Combination
Middle Aged
Nifedipine / therapeutic use
Trimetazidine / therapeutic use*
Reg. No./Substance:
0/Adrenergic beta-Antagonists; 0/Calcium Channel Blockers; 21829-25-4/Nifedipine; 5011-34-7/Trimetazidine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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