84543
document
Trimetazidine : a new concept in the treatment of angina . Comparison with propranolol in patients with stable angina . Trimetazidine European Multicenter Study Group . 1 . Trimetazidine has a direct anti-ischaemic effect on the myocardium without altering the rate x pressure product or coronary blood flow . 2 . The effects of trimetazidine ( 20 mg three times daily ) were compared with those of propranolol ( 40 mg three times daily ) in a double-blind parallel group multicentre study in 149 men with stable angina . 3 . Reproducibility of exercise performance was verified during a 3 week run-in placebo washout period . All patients had > 1 mm ST-depression on exercise test . 4 . After 3 months , similar anti-anginal efficacy was observed between the trimetazidine ( n = 71 ) and propranolol ( n = 78 ) groups . No significant differences were observed between trimetazidine and propranolol as regards anginal attack rate per week ( mean difference P-TMZ : 2 ; 95 % CI : -4.4 , 0.5 ) and exercise duration ( mean difference P-TMZ : 0 s ; 95 % CI : -33 , 34 ) or time to 1 mm ST segment depression ( mean difference P-TMZ : 13 s ; 95 % CI : -24 , 51 ) . Heart rate and rate x pressure product at rest and at peak exercise remained unchanged in the trimetazidine group but significantly decreased with propranolol ( P < 0.001 in all cases ) . With both drugs there was a trend to decreased ischaemic episodes in the 46 % patients who experienced ambulatory ischaemia on Holter monitoring . Six patients stopped trimetazidine and 12 propranolol . Of these , five in each group were withdrawn because of deterioration in cardiovascular status . 5 . The results suggest that trimetazidine and propranolol at the doses studied have similar efficacy in patients with stable angina pectoris . ( ABSTRACT TRUNCATED AT 250 WORDS )
84544
Intervention_Pharmacological
Trimetazidine
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Intervention_Pharmacological
propranolol
84546
Intervention_Pharmacological
Trimetazidine
84547
Intervention_Pharmacological
trimetazidine
84548
Intervention_Pharmacological
propranolol
84549
Intervention_Pharmacological
trimetazidine
84550
Intervention_Pharmacological
propranolol
84551
Intervention_Pharmacological
trimetazidine
84552
Intervention_Pharmacological
propranolol
84553
Intervention_Pharmacological
trimetazidine
84554
Intervention_Pharmacological
propranolol
84555
Intervention_Pharmacological
trimetazidine
84556
Intervention_Pharmacological
propranolol
84557
Outcome_Physical
anti-ischaemic effect
84558
Outcome_Physical
rate x pressure product
84559
Outcome_Physical
coronary blood flow
84560
Outcome_Other
anti-anginal efficacy
84561
Outcome_Physical
anginal attack rate per week
84562
Outcome_Physical
exercise duration
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Outcome_Physical
ST segment depression
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Outcome_Physical
Heart rate and rate x pressure product at rest
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Outcome_Physical
ischaemic episodes
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Outcome_Other
withdrawn
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Participant_Condition
stable angina .
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Participant_Sample-size
149
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Participant_Condition
men with stable angina .