PMID- 16949492
OWN - NLM
STAT- MEDLINE
DCOM- 20060921
LR  - 20131121
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 48
IP  - 5
DP  - 2006 Sep 5
TI  - A randomized clinical trial of trimetazidine, a partial free fatty acid oxidation 
      inhibitor, in patients with heart failure.
PG  - 992-8
AB  - OBJECTIVES: This study sought to assess whether the long-term addition of 
      trimetazidine to conventional treatment could improve functional class, exercise 
      tolerance, and left ventricular function in patients with heart failure (HF). 
      BACKGROUND: Previous small studies have shown that trimetazidine may be 
      beneficial in terms of left ventricular function preservation and control of 
      symptoms in patients with post-ischemic HF. METHODS: Fifty-five patients with HF 
      were randomly allocated in an open-label fashion to either conventional therapy 
      plus trimetazidine (20 mg three times daily) (28 patients) or conventional 
      therapy alone (27 patients). Mean follow-up was 13 +/- 3 months. At study entry 
      and at follow-up, all patients underwent exercise testing and two-dimensional 
      echocardiography. Among the others, New York Heart Association (NYHA) functional 
      class and ejection fraction (EF) were evaluated. RESULTS: In the trimetazidine 
      group, NYHA functional class significantly improved compared with the 
      conventional therapy group (p < 0.0001). Treatment with trimetazidine 
      significantly decreased left ventricular end-systolic volume (from 98 +/- 36 ml 
      to 81 +/- 27 ml, p = 0.04) and increased EF from 36 +/- 7% to 43 +/- 10% (p = 
      0.002). On the contrary, in the conventional therapy group, both left ventricular 
      end-diastolic and -systolic volumes increased from 142 +/- 43 ml to 156 +/- 63 
      ml, p = 0.2, and from 86 +/- 34 ml to 104 +/- 52 ml, p = 0.1, respectively; 
      accordingly, EF significantly decreased from 38 +/- 7% to 34 +/- 7% (p = 0.02). 
      CONCLUSIONS: In conclusion, long-term trimetazidine improves functional class and 
      left ventricular function in patients with HF. This benefit contrasts with the 
      natural history of the disease, as shown by the decrease of EF in patients on 
      standard HF therapy alone.
FAU - Fragasso, Gabriele
AU  - Fragasso G
AD  - Clinical Cardiology-Heart Failure Unit, Istituto Scientifico-Universita 
      Vita/Salute San Raffaele, Milan, Italy. gabriele.fragasso@hsr.it
FAU - Palloshi, Altin
AU  - Palloshi A
FAU - Puccetti, Patrizia
AU  - Puccetti P
FAU - Silipigni, Carmen
AU  - Silipigni C
FAU - Rossodivita, Alessandra
AU  - Rossodivita A
FAU - Pala, Mariagrazia
AU  - Pala M
FAU - Calori, Giliola
AU  - Calori G
FAU - Alfieri, Ottavio
AU  - Alfieri O
FAU - Margonato, Alberto
AU  - Margonato A
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20060817
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Vasodilator Agents)
RN  - N9A0A0R9S8 (Trimetazidine)
SB  - IM
CIN - J Am Coll Cardiol. 2006 Sep 5;48(5):999-1000. PMID: 16949493
MH  - Aged
MH  - Aged, 80 and over
MH  - Cardiac Output, Low/*drug therapy
MH  - Echocardiography
MH  - Exercise Test
MH  - Exercise Tolerance
MH  - Female
MH  - Heart/drug effects
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardium/*metabolism
MH  - Treatment Outcome
MH  - Trimetazidine/*therapeutic use
MH  - Vasodilator Agents/*therapeutic use
MH  - Ventricular Function, Left
EDAT- 2006/09/05 09:00
MHDA- 2006/09/22 09:00
CRDT- 2006/09/05 09:00
PHST- 2005/10/27 00:00 [received]
PHST- 2006/03/03 00:00 [revised]
PHST- 2006/03/30 00:00 [accepted]
PHST- 2006/09/05 09:00 [pubmed]
PHST- 2006/09/22 09:00 [medline]
PHST- 2006/09/05 09:00 [entrez]
AID - S0735-1097(06)01640-8 [pii]
AID - 10.1016/j.jacc.2006.03.060 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2006 Sep 5;48(5):992-8. doi: 10.1016/j.jacc.2006.03.060. Epub 
      2006 Aug 17.