Effect of trimetazidine in patients with stable exertional angina

Objective To assess the anti anginal efficacy and the acceptability of trimetazidine (TMZ) in combination with conventional treatment in patients with stable exertional angina in China. Methods One hundred and thirty eight stable exertional angina patients with two positive exercise tests within one week and the difference of duration of exercise between two tests ≤10% were included. TMZ 20 mg tid was combined with any one of the three traditional medications including β blockers, calcium antagonists or long acting nitrates. The total period of treatment was 12 weeks. The data from 131 patients who completed the study were used for statistical analysis. Results The results showed that TMZ significantly increased exercise duration, total work load, time to onset of angina and time to 1 mm ST segment depression (P0 001). After treatment, 32 patients (24.43%) no longer showed ST depression ≥1 mm during exercise, however, rate pressure product did not change significantly (P0 05). TMZ reduced the number of anginal attacks and the mean nitrate consumption per week. The changes were significantly different. This may be associated with a decrease of grades of exertional angina. During the period of TMZ therapy, there were very few adverse drug effects reported, including one insomnia, one discomfortable feeling in upper abdomen, one headache, one rash, one palpitation and one case with dizziness, weakness and increased heart rate. Conclusion For patients with stable exertional angina, TMZ 20 mg three times daily in combination with existing therapy increases the exercise capacity. The drug is safe and effective and well tolerated by patients.