DOI: https://doi.org/10.22141/2224-1485.1.57.2018.125496

Efficacy and safety of trimetazidine (Сarmetadin) in the comprehensive treatment of patients with ischemic heart disease and chronic heart failure

O.O. Khaniukov, O.V. Pysarevska, M.G. Getman, T.A. Simonova, T.V. Lakiza

Abstract


The purpose of study was to assess the effectiveness and safety of trimetazidine (Сarmetadin) in the comprehensive treatment of patients with ischemic heart disease and chronic heart failure. Eighty persons with ischemic heart disease (stable angina pectoris, II–III functional class) and chronic heart failure (II–III functional class, New York Heart Association classification) were included in our investigation. We performed standard clinical investigation, evaluation of laboratory indices, electrocardiography, echocardiography, daily monitoring of electrocardiogram. Patients were divided into two groups. Forty persons of the control group received comprehensive treatment — antithrombotic therapy (aspirin — 100 mg per day), beta-blocker (bisoprolol — 5–10 mg per day, depending on the initial heart rate and blood pressure, with previous dose titration), angiotensin-converting enzyme inhibitor (ramipril — 5–10 mg per day, depending on the initial blood pressure, with previous dose titration), statin (rosuvastatin — 20 mg per day) and, if necessary, nitrates and diuretics were recommended. Forty patients of the main group additionally took Сarmetadin (35 mg twice daily, modified release tablets). Observation period was 6 months. The use of Сarmetadin in the comprehensive therapy of ischemic heart disease and chronic heart failure was associated with improvement of patients’ quality of life, significant decrease in the number and duration of angina attacks, reduction of the demand for short-acting nitrates, improvement of the functional class of chronic heart failure, increase in the left ventricular ejection fraction. Besides, comprehensive treatment with Сarmetadin was well tolerated by patients — serious adverse effects were not registered.

Keywords


ischemic heart disease; chronic heart failure; treatment; Сarmetadin

References


Акимов А.Г. Перспективы применения миокардиальных цитопротекторов в кардиологической практике / А.Г. Акимов, В.Ю. Полумисков // Terra Medica. — 2005. — Vol. 4. — С. 24-31.

Амосова Е.Н. Метаболическая терапия повреждений миокарда, обусловленная ишемией. Новый подход к лечению ишемической болезни сердца и сердечной недостаточности / Е.Н. Амосова // Укр. кардиол. журнал. — 2000. — № 4. — С. 86-92.

Малиновская И.Э. Клиническая эффективность триметазидина у пациентов, перенесших острый инфаркт миокарда / И.Э. Малиновская, Т.М. Терещенко // Ліки України. — 2016. — № 10. — С. 87-90.

Проблеми здоров’я і медичної допомоги та модель покращання в сучасних умовах / За ред. В.М. Коваленка, В.М. Корнацького. — К.: Гордон, 2016. — 262 с.

Серцево-судинні захворювання. Класифікація, стандарти діагностики та лікування / За ред. В.М. Коваленка, М.І. Лутая, Ю.М. Сіренка, О.С. Сичова. — К.: Моріон, 2016. — 192 с.

Belardinelli R. Trimetazidine improves endothelial dysfunction in chronic heart failure: an antioxidant effect / R. Belardinelli, M. Solenghi, L. Volpe, A. Purcaro // Eur. Heart J. — 2007. — Vol. 28. — P. 1102-1108.

Boden W. Optimal medical therapy with or without PCI for stable coronary disease / W. Boden, R. O’Rourke, K. Teo // N. Engl. J. Med. — 2007. — Vol. 356. — P. 1503-1516.

Cross H. Trimetazidine for stable angina pectoris / H. Cross // Expert. Opin. Pharmacother. — 2001. — Vol. 2. — P. 857-875.

Daly C. The initial management of stable angina in Europe, from the Euro Heart Survey: a description of pharmacological management and revascularization strategies initiated within the first month of presentation to a cardiologist in the Euro Heart Survey of Stable Angina / C. Daly, F. Clemens, J. Lopez-Sendon // Eur. Heart J. — 2005. — Vol. 26. — P. 1011-1022.

Di Napoli P. Anti-ischemic cardioprotection with trimetazidine / P. Di Napoli // Heart Metab. — 2008. — Vol. 41. — P. 25-29.

Doenst T. Cardiac metabolism in heart failure: implications beyond ATP production / T. Doenst, T.D. Nguyen, E.D. Abel // Circ. Res. — 2013. — Vol. 113 (6). — P. 709-724.

Gao D. Trimetazidine: a meta-analysis of randomized controlled trials in heart failure / D. Gao, N. Ning, X. Niu // Heart. — 2011. — Vol. 97. — P. 278-286.

Henderson R. Seven-year outcome in the RITA-2 trial: coronary angioplasty versus medical treatment / R. Henderson, S. Pocock, T. Clayton // J. Am. Coll. Cardiol. — 2003. — Vol. 42. — P. 1161-1170.

Jespersen L. Stable angina pectoris with no obstructive coronary artery disease is associated with increased risk of major adverse cardiovascular events / L. Jespersen, A. Hvelplund, S. Abildstrom // Eur. Heart J. — 2012. — Vol. 33. — P. 734-744.

Marzilli M. Cardioprotective effects of trimetazidine: a review / M. Marzilli // Curr. Med. Res. Opin. — 2003. — Vol. 19. — P. 661-672.

Marzilli M. Obstructive coronary atherosclerosis and ischemic heart disease: an elusive link! / M. Marzilli, C. Merz, W. Boden // J. Am. Coll. Cardiol. — 2012. — Vol. 60. — P. 951-956.

Milinkovic I. Clinical benefits of treating angina directly at the cardiac cell level with trimetazidine / I. Milinkovic, A. Coats, G. Rosano // Heart Metab. — 2017. — Vol. 72. — P. 25-31.

Montalescot G. 2013 ESC guidelines on the management of stable coronary disease: the Task Force on the management of stable coronary disease of the European Society of Cardiology / G. Montalescot, U. Sechtem, S. Achenbach // Eur. Heart J. — 2013. — Vol. 34. — P. 2949-3003.

Lopatin Y. Rationale and benefits of trimetazidine by ac-ting on cardiac metabolism in heart failure / Y. Lopatin, G. Rosano, G. Fragasso // Int. J. Cardiol. — 2016. — Vol. 203. — P. 909-915.

Patel M. Low diagnostic yield of elective coronary angiography / M. Patel, E. Peterson, D. Dai // N. Engl. J. Med. — 2010. — Vol. 362. — P. 886-895.

Pijls N. Measurement of fractional flow reserve to assess the functional severity of coronary artery stenosis / N. Pijls, B. De Bruyne, K. Peels // N. Engl. J. Med. — 1996. – Vol. 334. — P. 1703-1708.

Rosano G. Metabolic approach to heart failure: the role of metabolic modulators / G. Rosano, C. Vitale, I. Spoletini // The Egyptian Heart Journal. — 2015. — Vol. 67. — P. 177-181.

Tsioufis K. Trimetazidine and cardioprotection: facts and perspectives / K. Tsioufis, G. Andrikopoulos, A. Manolis // Angio­logy. — 2015. — Vol. 66. — P. 204-210.

Villines T. CONFIRM Registry Investigators. Prevalence and severity of coronary artery disease and adverse events among symptomatic patients with coronary artery calcification scores of zero undergoing coronary computed tomography angiography: results from the CONFIRM (Coronary CT Angiography Evaluation for Clinical Outcomes: an International Multicenter) registry / T. Villines, E. Hulten, L. Shaw // J. Am. Coll. Cardiol. — 2011. — Vol. 58. — P. 2533-2540.

Vitale C. Trimetazidine improves left ventricular function and quality of life in elderly patients with coronary artery disease / C. Vitale, M. Wajngaten, B. Sposato // Eur. Heart J. — 2004. — Vol. 25. — P. 1814-1821.

Weintraub W. Effects of PCI on quality of life in patients with stable coronary artery disease / W. Weintraub, J. Spertus, P. Kolm // N. Engl. J. Med. — 2008. — Vol. 359. — P. 677-687.

Zhang L. Additional use of trimetazidine in patients with chronic heart failure: a meta-analysis / L. Zhang, Y. Lu, H. Jiang // J. Am. Coll. Cardiol. — 2012. — Vol. 59. — P. 913-922.

Zhao Y. Trimetazidine improves exercise tolerance in patients with ischemic heart disease: a meta-analysis / Y. Zhao, L. Peng, Y. Luo // Herz. — 2016. — Vol. 41. — P. 514-522.

Zhou X. Is treatment with trimetazidine beneficial in patients with chronic heart failure? / X. Zhou, J. Chen // PLoS One. — 2014. — Vol. 9. — e94660.




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