TY - JOUR
T1 - A Randomized Clinical Trial of Trimetazidine, a Partial Free Fatty Acid Oxidation Inhibitor, in Patients With Heart Failure
AU - Fragasso, Gabriele
AU - Palloshi, Altin
AU - Puccetti, Patrizia
AU - Silipigni, Carmen
AU - Rossodivita, Alessandra
AU - Pala, Mariagrazia
AU - Calori, Giliola
AU - Alfieri, Ottavio
AU - Margonato, Alberto
PY - 2006/9/5
Y1 - 2006/9/5
N2 - 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.
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.
UR - http://www.scopus.com/inward/record.url?scp=33747887613&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=33747887613&partnerID=8YFLogxK
U2 - 10.1016/j.jacc.2006.03.060
DO - 10.1016/j.jacc.2006.03.060
M3 - Article
C2 - 16949492
AN - SCOPUS:33747887613
VL - 48
SP - 992
EP - 998
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 5
ER -