| Comparison of trimetazidine plus sildenafil to chronic nitrates in the control of myocardial ischemia during sexual activity in patients with coronary artery disease. | |
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MedLine Citation:
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PMID: 15670539 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A large proportion of patients who have erectile dysfunction also have coronary artery disease (CAD). In these patients, nitrate therapy is a contraindication to the use of sildenafil. To assess whether the metabolic anti-ischemic agent, trimetazidine, is effective in controlling episodes of myocardial ischemia during sexual activity in patients who have CAD and use long-term nitrate therapy, we studied 38 men (57 +/- 6 years of age) who had proved CAD. Patients underwent 24-hour ambulatory electrocardiographic monitoring at baseline, after 1 week of oral nitrate therapy (20 mg 3 times a day), and after 1 week of trimetazidine (20 mg 3 times a day). Patients were asked to engage in >/=1 session of sexual intercourse during each session of ambulatory electrocardiographic monitoring. They were instructed to take sildenafil (100 mg) 1 hour before sexual intercourse performed at baseline and during therapy with trimetazidine and sildenafil or placebo (blinded) during therapy with nitrates. A decrease in total ischemic burden was observed with nitrates and trimetazidine compared with baseline (-3 +/- 1.2 episodes/patient/24 hours vs -5 +/- 1.3 episodes/patient/24 hours and -6 +/- 5 min/patient/24 hours vs -8 +/- 3 min/patient/24 hours, p <0.01 for nitrates and trimetazidine vs baseline). Trimetazidine plus sildenafil was more effective in controlling episodes of myocardial ischemia during sexual activity than nitrates alone (-45 +/- 11% vs -18 +/- 7%, p <0.04). In conclusion, in patients who have CAD, combination therapy with sildenafil and trimetazidine is more effective than nitrate therapy in the control of ischemic episodes during sexual activity, suggesting that long-term nitrate therapy may be safely switched to trimetazidine therapy when therapy for erectile dysfunction is required. |
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Authors:
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Giuseppe M C Rosano; Giuseppe Marazzi; Roberto Patrizi; Elena Cerquetani; Cristiana Vitale; Maurizio Volterrani; Massimo Fini; Giuseppe Mercuro |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 95 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2005 Feb |
Date Detail:
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Created Date: 2005-01-26 Completed Date: 2005-03-24 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 327-31 Citation Subset: AIM; IM |
Affiliation:
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Department of Medical Sciences, Cardiovascular Research Unit, San Raffaele, Rome, Italy. rosanog@mclink.it |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Analysis of Variance Coitus* Cross-Over Studies Double-Blind Method Drug Therapy, Combination Electrocardiography, Ambulatory Erectile Dysfunction / drug therapy* Humans Male Middle Aged Myocardial Ischemia / prevention & control* Nitrates / therapeutic use Phosphodiesterase Inhibitors / therapeutic use* Piperazines / therapeutic use* Purines Sulfones Treatment Outcome Trimetazidine / therapeutic use* Vasodilator Agents / therapeutic use* |
| Chemical | |
Reg. No./Substance:
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0/Nitrates; 0/Phosphodiesterase Inhibitors; 0/Piperazines; 0/Purines; 0/Sulfones; 0/Vasodilator Agents; 139755-83-2/sildenafil; 5011-34-7/Trimetazidine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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