THE ROLE OF TRIMETAZIDINE DRUG IN POST-MYOCARDIAL INFARCTION CONDITION

Abstract

The efficacy of trimetazidine, an anti-ischaemic agent, has been largely assessed
and presented in the international literature through its metabolic effects, selective and
specific fatty acid oxidation inhibition and lack of haemodynamic effects in stable
angina pectoris. As such, trimetazidine has opened up a new class of metabolic agents
that reduce fatty acid oxidation: the 3-KAT (3-ketoacyl-CoAthiolase) inhibitors.The
aim of this review article is to demonstrate the cardioprotective benefits of
trimetazidine, and how this can be translated into positive effects in the treatment of
cardiac disorders. Trimetazidine has been assessed in several double-blind randomised
studies as a treatment of ischaemic heart disease or as an agent given prior to or during
percutaneous transluminal coronary angioplasty, coronary artery bypass grafting and
thrombolysis to prevent or limit ischaemia/reperfusion damage in the heart. All these
studies demonstrate that trimetazidine protects the heart from the deleterious
consequences of ischaemia by switching cardiac metabolism from fatty acid oxidation
to glucose oxidation. Study results cast no doubts on the value of the cardioprotective
effects of trimetazidine and support the fact that trimetazidine has a direct anti-
ischaemic effect on human myocardial cells. Trimetazidine has proven antianginal
efficacy, and can be also used in other cardiac diseases with ischaemic signs.