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. 1994 Mar;37(3):279–288. doi: 10.1111/j.1365-2125.1994.tb04276.x

Trimetazidine: a new concept in the treatment of angina. Comparison with propranolol in patients with stable angina. Trimetazidine European Multicenter Study Group.

J M Detry 1, P Sellier 1, S Pennaforte 1, D Cokkinos 1, H Dargie 1, P Mathes 1
PMCID: PMC1364760  PMID: 8198938

Abstract

1. Trimetazidine has a direct anti-ischaemic effect on the myocardium without altering the rate x pressure product or coronary blood flow. 2. The effects of trimetazidine (20 mg three times daily) were compared with those of propranolol (40 mg three times daily) in a double-blind parallel group multicentre study in 149 men with stable angina. 3. Reproducibility of exercise performance was verified during a 3 week run-in placebo washout period. All patients had > 1 mm ST-depression on exercise test. 4. After 3 months, similar anti-anginal efficacy was observed between the trimetazidine (n = 71) and propranolol (n = 78) groups. No significant differences were observed between trimetazidine and propranolol as regards anginal attack rate per week (mean difference P-TMZ: 2; 95% CI: -4.4, 0.5) and exercise duration (mean difference P-TMZ: 0 s; 95% CI: -33, 34) or time to 1 mm ST segment depression (mean difference P-TMZ: 13 s; 95% CI: -24, 51). Heart rate and rate x pressure product at rest and at peak exercise remained unchanged in the trimetazidine group but significantly decreased with propranolol (P < 0.001 in all cases). With both drugs there was a trend to decreased ischaemic episodes in the 46% patients who experienced ambulatory ischaemia on Holter monitoring. Six patients stopped trimetazidine and 12 propranolol. Of these, five in each group were withdrawn because of deterioration in cardiovascular status. 5. The results suggest that trimetazidine and propranolol at the doses studied have similar efficacy in patients with stable angina pectoris.(ABSTRACT TRUNCATED AT 250 WORDS)

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Selected References

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  1. Boddeke E., Hugtenburg J., Jap W., Heynis J., van Zwieten P. New anti-ischaemic drugs: cytoprotective action with no primary haemodynamic effects. Trends Pharmacol Sci. 1989 Oct;10(10):397–400. doi: 10.1016/0165-6147(89)90187-9. [DOI] [PubMed] [Google Scholar]
  2. Brottier L., Barat J. L., Combe C., Boussens B., Bonnet J., Bricaud H. Therapeutic value of a cardioprotective agent in patients with severe ischaemic cardiomyopathy. Eur Heart J. 1990 Mar;11(3):207–212. doi: 10.1093/oxfordjournals.eurheartj.a059685. [DOI] [PubMed] [Google Scholar]
  3. Campeau L. Letter: Grading of angina pectoris. Circulation. 1976 Sep;54(3):522–523. [PubMed] [Google Scholar]
  4. Dalla-Volta S., Maraglino G., Della-Valentina P., Viena P., Desideri A. Comparison of trimetazidine with nifedipine in effort angina: a double-blind, crossover study. Cardiovasc Drugs Ther. 1990 Aug;4 (Suppl 4):853–859. doi: 10.1007/BF00051292. [DOI] [PubMed] [Google Scholar]
  5. Detry J. M., Fesler R., Berckmans T., Leclercq P. A new semiautomated algorithm to quantify Holter-detected myocardial ischemia: preliminary experience in the Trimetazidine European Multicenter trial (TEMS). Cardiovasc Drugs Ther. 1990 Aug;4 (Suppl 4):841–846. doi: 10.1007/BF00051290. [DOI] [PubMed] [Google Scholar]
  6. Fabiani J. N., Ponzio O., Emerit I., Massonet-Castel S., Paris M., Chevalier P., Jebara V., Carpentier A. Cardioprotective effect of trimetazidine during coronary artery graft surgery. J Cardiovasc Surg (Torino) 1992 Jul-Aug;33(4):486–491. [PubMed] [Google Scholar]
  7. Furberg B., Dahlqvist A., Raak A., Wrege U. Comparison of the new beta-adrenoceptor antagonist, nadolol, and propranolol in the treatment of angina pectoris. Curr Med Res Opin. 1978;5(5):388–393. doi: 10.1185/03007997809111903. [DOI] [PubMed] [Google Scholar]
  8. Gobel F. L., Norstrom L. A., Nelson R. R., Jorgensen C. R., Wang Y. The rate-pressure product as an index of myocardial oxygen consumption during exercise in patients with angina pectoris. Circulation. 1978 Mar;57(3):549–556. doi: 10.1161/01.cir.57.3.549. [DOI] [PubMed] [Google Scholar]
  9. Guarnieri C., Muscari C. Beneficial effects of trimetazidine on mitochondrial function and superoxide production in the cardiac muscle. Cardiovasc Drugs Ther. 1990 Aug;4 (Suppl 4):814–815. doi: 10.1007/BF00051282. [DOI] [PubMed] [Google Scholar]
  10. Hugtenburg J. G., Jap T. J., Mathy M. J., van Heiningen P. N., Bohnenn V. A., Heijnis J. B., Boddeke H. W., van Zwieten P. A. Cardioprotective effect of trimetazidine and nifedipine in guinea-pig hearts subjected to ischaemia. Arch Int Pharmacodyn Ther. 1989 Jul-Aug;300:186–208. [PubMed] [Google Scholar]
  11. Kober G., Buck T., Sievert H., Vallbracht C. Myocardial protection during percutaneous transluminal coronary angioplasty: effects of trimetazidine. Eur Heart J. 1992 Aug;13(8):1109–1115. doi: 10.1093/oxfordjournals.eurheartj.a060322. [DOI] [PubMed] [Google Scholar]
  12. Maridonneau-Parini I., Harpey C. Effect of trimetazidine on membrane damage induced by oxygen free radicals in human red cells. Br J Clin Pharmacol. 1985 Aug;20(2):148–151. doi: 10.1111/j.1365-2125.1985.tb05047.x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature. Circulation. 1979 Mar;59(3):607–609. doi: 10.1161/01.cir.59.3.607. [DOI] [PubMed] [Google Scholar]
  14. Pepine C. J. Ambulant myocardial ischemia and its prognostic implications. Circulation. 1990 Mar;81(3):1136–1138. doi: 10.1161/01.cir.81.3.1136. [DOI] [PubMed] [Google Scholar]
  15. Renaud J. F. Internal pH, Na+, and Ca2+ regulation by trimetazidine during cardiac cell acidosis. Cardiovasc Drugs Ther. 1988 Mar;1(6):677–686. doi: 10.1007/BF02125756. [DOI] [PubMed] [Google Scholar]
  16. Sellier P., Audouin P., Payen B., Corona P., Duong T. C., Ourbak P. Acute effects of trimetazidine evaluated by exercise testing. Eur J Clin Pharmacol. 1987;33(2):205–207. doi: 10.1007/BF00544569. [DOI] [PubMed] [Google Scholar]
  17. Sellier P. Effets de la trimétazidine sur les paramètres ergométriques dans l'angor d'effort. Etude multicentrique contrôlée à double insu contre placebo. Arch Mal Coeur Vaiss. 1986 Aug;79(9):1331–1336. [PubMed] [Google Scholar]
  18. Thadani U., Parker J. O. Propranolol in the treatment of angina pectoris. Comparison of duration of action in acute and sustained oral therapy. Circulation. 1979 Mar;59(3):571–579. doi: 10.1161/01.cir.59.3.571. [DOI] [PubMed] [Google Scholar]

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