XU X et al. Clin Drug Investig (2014) 34:251–258
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Can we improve the management of angina patients after percutaneous coronary intervention? Beneficial effects of adding trimetazidine MR therapy after PCI in multivessel coronary heart disease patients with diabetes mellitus XU X et al. Clin Drug Investig (2014) 34:251–258 PCI: percutaneous coronary intervent
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Can we improve the management of angina patients after percutaneous coronary intervention ? Beneficial effects of adding trimetazidine MR therapy after PCI in multivessel coronary heart disease patients with diabetes mellitus. PCI: percutaneous coronary intervention. - PowerPoint PPT Presentation
Transcript of XU X et al. Clin Drug Investig (2014) 34:251–258
Can we improvethe management of angina patients after
percutaneous coronary intervention?
Beneficial effects of adding trimetazidine MR therapyafter PCI in multivessel coronary heart disease
patients with diabetes mellitus
XU X et al. Clin Drug Investig (2014) 34:251–258
PCI: percutaneous coronary intervention
Treating angina by exclusively targetingcoronary obstruction is insufficient
Boden et al. (COURAGE Study). N Engl J Med. 2007;356:1503-1516.
Beneficial effects of trimetazidine therapyin CHD patients after PCI
Methods
700 coronary heart disease (CHD) patients with diabetes mellitus (DM) who were
aged 65 years and undergoing coronary angiography were randomized.
Half of them received trimetazidine 20 mg three times daily after stent implantation as
an addition to conventional CHD treatment. The other half received conventional
treatment alone (approx. 70% of patients were taking -blockers).
Primary end point:
Incidence of recurrent angina pectoris
measures of various echocardiographic parameters.
XU X et al. Clin Drug Investig (2014) 34:251–258
Results
Compared with the control group, trimetazidine significantly reduced recurrent angina
pectoris (P=0.010) and silent myocardial ischemia (P=0.009).
Beneficial effects of trimetazidine therapyin CHD patients after PCI
XU X et al. Clin Drug Investig (2014) 34:251–258
Results
Left ventricular function and left ventricular structure were both relatively stable in
trimetazidine-treated patients after 2 years of follow-up, while they deteriorated in the
control group with a significant difference between groups (all P<0.01).
Beneficial effects of trimetazidine therapyin CHD patients after PCI
XU X et al. Clin Drug Investig (2014) 34:251–258
Results
Independent predictors of recurrent angina pectoris in the 2 years following PCI
included three-vessel disease, current smoking, BMI, and history of hypertension and
hypercholesterolemia, while trimetazidine treatment had a beneficial effect.
Beneficial effects of trimetazidine therapyin CHD patients after PCI
Trimetazidine:a predictor of protection
XU X et al. Clin Drug Investig (2014) 34:251–258
Beneficial effects of trimetazidine therapyin CHD patients after PCI
Discussion
XU X et al. Clin Drug Investig (2014) 34:251–258
Conclusion
About one-third of patients still have angina after myocardial revascularization.
Trimetazidine effectively reduces recurrent angina and preserves left ventricular function in patients with multivessel CHD and DM.
These benefits could be linked to the mode of action of trimetazidine MR. By directly providing a 33% increase in the energy supplied to the cardiac cells, trimetazidine MR effectively reduces angina and provides unique cardioprotective benefits.
