Insight into cytoprotection with metabolic agents

A. Cargnoni, E. Pasini, C. Ceconi, S. Curello, R. Ferrari

Research output: Contribution to journalArticlepeer-review


Trimetazidine (TMZ) is a derivative of piperazine used for the treatment of angina pectoris. The anti-ischaemic effect of TMZ occurs without any major effect on haemodynamics or myocardial oxygen consumption. The identification of TMZ's mechanism of metabolic cytoprotective action has been the field of research of several investigational groups. The purpose of this paper is to review critically the existing data from literature relevant to this field. Moreover, an analysis of the hypothesized mechanisms of TMZ's metabolic cytoprotective action is also presented. Due to the different models used, the results of these experimental studies are quite controversial, offering several mechanisms of action that could all explain the efficacy of TMZ as an antianginal drug. The most credible ones are: (1) TMZ positively influences the myocardial energetic metabolism; (2) TMZ reduces the utilization of the fatty acids in favour of carbohydrates; (3) TMZ reduces the toxicity of oxygen; and (4) TMZ reduces the inflammatory process. Review of the existing data suggests that each of the proposed mechanisms is not exclusive but is involved, along with the others, in determining the cytoprotective effect of TMZ.

Original languageEnglish
JournalEuropean Heart Journal, Supplement
Issue numberO
Publication statusPublished - 1999


  • Anti-ischaemic effect
  • Cytoprotective effect
  • Metabolic effect
  • Trimetazidine angina pectoris

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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