Cor Vasa 2005, 46(12):470-474
TRIADA - (TRImetazidine in stable Angina twice DAily). Evaluation of the efficacy and tolerability of Preductal MR in patients with stable angina
- Oddělení funkčního vyšetřování, Fakultní nemocnice Brno-Bohunice, Brno, Česká republika
Trimetazidine (TMZ) is the first representative of a new class of antianginal agents, so called metabolic modulators, to be used in clinical practice. Essentially, its effect is based on selective inhibition of the mitochondrial fatty acid beta-oxidation enzyme 3-ketoacyl-CoA-thiolase (3-KAT). The result is partial inhibition of fatty acid oxidation and stimulation of glucose oxidation. The shift of energy generation from fatty acid beta-oxidation to aerobic glycolysis results in more effective utilization of residual oxygen in the ischemic myocardium and maintenance of macroergic phosphate formation. An advantage of TMZ is that, unlike conventional antianginal agents, it has no effect on hemodynamic parameters. Trimetazidine possesses demonstrable anti-ischemic and antianginal effects in monotherapy and in combination therapy in patients with stable angina pectoris (AP). A nationwide study called TRIADA was completed this year. The study included 74 patients with stable exertional AP and positive exercise testing results. Trimetazidine (Preductal MR) at a dose of 35 mg twice daily was added to their current therapy involving two drugs at most. The outcome was evaluated after 12 weeks of therapy and compared with baseline data. TRIADA confirmed that the use of TMZ in a new pharmacological form is effective and well tol-erated in the treatment of AP. The study also confirmed a beneficial effect of TMZ on the incidence of AP paroxysms and objective manifestations of ischemia during exercise testing. Holter monitoring clearly showed that metabolic therapy added to standard antianginal therapy would reduce the incidence of symptomatic and asymptomatic ischemia. Additionally,
12-week therapy with TMZ helped improve all end points of quality of life of AP patients, as evaluated using a question-naire for AP patients (The Seattle Angina Questionnaire).
Keywords: Angina pectoris; Antianginal therapy; Quality of life; 3-KAT inhibitors; Trimetazidine
Published: December 1, 2005 Show citation