Maciej Banach, Jacek Rysz, Aleksander Goch, Dimitri P. Mikhailidis and Giuseppe M.C. Rosano Pages 282 - 291 ( 10 )
“Metabolic treatment” involves the use of drugs to improve cardiomyocyte function. Trimetazidine is the most investigated drugs in this group. The ESC 2006 guidelines on the management of patients with stable angina mention the efficacy of metabolic treatment in improving physical efficiency and decreasing the recurrence of pain. The available data suggest that combined therapy of trimetazidine and haemodynamic drugs is an effective antianginal treatment that reduces the risk of pain recurrence (in as many as 64% of patients). The most recent studies also suggest that trimetazidine might be effective in patients with acute coronary syndromes, ischemic cardiomyopathy and heart failure. However, while trimetazidine has shown beneficial effects on surrogate endpoints in several small trials its effect on cardiovascular events is uncertain. Further large randomized studies are needed before its effects on cardiovascular events can be evaluated.
Acute coronary syndromes, metabolic treatment, trimetazidine
Department of Cardiology, 1st Chair of Cardiology and Cardiac Surgery, Medical University of Lodz, Sterlinga 1/3, 91-425 Lodz, Poland.