TITLE

Trimetazidine

AUTHOR(S)
McClellan, Karen J.; Plosker, Greg L.
PUB. DATE
July 1999
SOURCE
Drugs;Jul1999, Vol. 58 Issue 1, p143
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The orally administered antianginal agent trimetazidine increases cell tolerance to ischaemia by maintaining cellular homeostasis. In theory, this cytoprotective activity should limit myocyte loss during ischaemia in patients with angina pectoris. Data from studies in patients with coronary artery disease indicate that, unlike the effects of other antianginals, the anti-ischaemic effects of trimetazidine 20mg are not associated with alterations in haemodynamic determinants of myocardial oxygen consumption such as heart rate, systolic blood pressure and the rate-pressure product. Furthermore, limited evidence suggests trimetazidine may improve left ventricular function in patients with chronic coronary artery disease or ischaemic cardiomyopathy and in patients experiencing acute periods of ischaemia when undergoing percutaneous transluminal coronary angioplasty. Clinical studies have shown that oral trimetazidine 20mg 3 times daily reduces the frequency of anginal attacks and nitroglycerin use and increases exercise capacity when used as monotherapy in patients with angina pectoris. Its clinical effects are broadly similar to those of nifedipine 40 mg/day and propranolol 120 to 160 mg/day but, unlike these agents, trimetazidine does not affect the rate-pressure product during peak exercise or at rest. Adjunctive trimetazidine 60 mg/day reduces the frequency of anginal attacks and nitroglycerin use and improves exercise capacity in patients with angina pectoris not sufficiently controlled by conventional antianginal agents. Furthermore, the drug appears to be more effective than isosorbide dinitrate 30 mg/day when used adjunctively in patients with angina pectoris poorly controlled by propranolol 120 mg/day. The tolerability profile of trimetazidine 60 mg/day was similar to that of placebo when used as add-on therapy in patients with angina pectoris insufficiently controlled by other antianginal agents and was superior to that of either nifedipine 40 mg/day or...
ACCESSION #
9523862

 

Related Articles

  • Importance of Identifying Left Main Coronary Artery Narrowing in Subsets of Patients with Coronary Artery Disease. Epstein, Stephen E. // Annals of Internal Medicine;Aug79, Vol. 91 Issue 2, p308 

    Editorial. Discusses the importance of identifying the narrowing of the left main coronary artery in subsets of patients with coronary artery disease. Patients with stable symptoms; Unstable angina.

  • The effect of caffeine on exercise tolerance and left ventricular function in patients with coronary artery disease. Hirsch, Alan T.; Gervino, Ernest V.; Nakao, Shoichiro; Come, Patricia C.; Silverman, Kenneth J.; Grossman, William; Hirsch, A T; Gervino, E V; Nakao, S; Come, P C; Silverman, K J; Grossman, W // Annals of Internal Medicine;4/15/89, Vol. 110 Issue 8, p593 

    Study Objective: To determine whether acute oral caffeine ingestion by patients with coronary artery disease results in decreased treadmill exercise performance or deterioration of echocardiographic measures of systolic or diastolic left ventricular function.Design:...

  • Are district general hospital patients with unstable angina at a disadvantage? Miller, C.; Lipscomb, K.; Curzon, N.; Curzen, N // Postgraduate Medical Journal;Feb2003, Vol. 79 Issue 928, p93 

    Objective: To determine whether patients with non-ST elevation acute coronary syndromes requiring coronary angiography and revascularisation have inferior access to these services if admitted to district general hospitals (DGHs) compared with similar patients admitted to a base...

  • Effort angina in a patient with advanced coronary artery disease. Role played by coronary angiography, Ivus and cardiac CT: case report. Zardi, Domenico M.; Zardi, Enrico M.; Berni, Andrea; Nannini, Cristiana; Pace, Biagio Andrea; Santucci, Stefano; Volpe, Massimo // Cardiovascular Ultrasound;2008, Vol. 6, Special section p1 

    Coronary angiography is considered to be the gold standard technique for assessing the severity of obstructive luminal narrowing; however, in a few circumstances it may be misleading. In these cases, cardiac computed tomography (CT) and intravascular ultrasound (IVUS) may help to give a correct...

  • Treatment of the patients with stable angina and chronic total coronary occlusion. Konstantinov, Igor M. // Vestnik Sankt-Peterburgskogo Universiteta, Seriia 9: Filologia, ;2013, Issue 3, p29 

    There is some confusion regarding the revascularization of patients with chronic total occlusions (CTO) and signs of ischemia. Improvement of left ventricle (LV) structure and function is one of the treatment goals. 32 patients with CTO of left anterior descending artery (LAD) were included in...

  • Pharmacological modulation of the ATP sensitive potassium channels during repeated coronary occlusions: no effect on myocardial ischaemia or function. Lindhardt, T. B.; Gadsbøll, N.; Kelbæk, H.; Saunamäki, K.; Madsen, J. K.; Clemmensen, P.; Hesse, B.; Haunsø, S. // Heart;Apr2004, Vol. 90 Issue 4, p425 

    Background: Repeated episodes of myocardial ischaemia may lead to ischaemic preconditioning. This is believed to be mediated by the AlP sensitive potassium channels. Objective: To examine the effect of pharmacological modulation of the ATP sensitive potassium channels during repeated coronary...

  • THE PATHOPHYSIOLOGY OF MYOCARDIAL ISCHAEMIA. Crossman, David C. // Heart;May2004, Vol. 90 Issue 5, p576 

    Myocardial ischaemia is responsible for angina, unstable angina, and, less commonly, shortness of breath secondary to ischaemic left ventricular dysfunction as well as cardiac arrhythmias. This article will deal with the mechanisms of myocardial ischaemia likely to be encountered in patients...

  • Treatment of intractable angina in a nonagenarian patient by direct coronary stenting. Byrne, Jonathan; Cotton, James M.; Wainwright, Raymond J. // Age & Ageing;Jul2001, Vol. 30 Issue 4 

    Focuses on the treatment of intractable angina in a nonagenarian patient by direct coronary stenting. Association of left main stem lesion with high mortality; Risks involved in balloon inflation; Consideration of coronary angioplasty as an alternative to bypass surgery in selected patients.

  • The right place at the right time.  // BMJ: British Medical Journal (International Edition);05/13/2000, Vol. 320 Issue 7245, p1307 

    Narrates the experiences of the author concerning his angina. Treatment he received; Information on angioplasty.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics