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Nicolas Danchin
As patients with coronary artery disease live longer and more often reach the stage where further myocardial revascularization procedures can no longer be performed, efficacious and well-tolerated antianginal medications are needed. Metabolic agents offer the advantage of controlling symptoms without untoward hemodynamic effects. This article reviews the epidemiology of stable angina and the use of antianginal medications in patients who have undergone myocardial revascularization. It also describes the clinical data on the anti-ischemic effects of metabolic agents in patients undergoing coronary artery bypass surgery or angioplasty, the latter in the setting of acute myocardial infarction and elective procedures...
September 4, 2006: American Journal of Cardiology
W Ruzyllo, H Szwed, Z Sadowski, W Elikowski, H Grzelak-Szafranska, W Orszulak, K Szymczak, M Winter
OBJECTIVES: The revascularization procedures become more and more popular to treat coronary artery disease, in many countries. Some patients are free of angina after revascularization, without any documented re-stenosis present with recurrent angina symptoms after a period of time. The aim of this work was to assess the efficacy of trimetazidine in the subpopulation of patients with a history of PTCA or CABG, who were included in the TRIMPOL II study. METHODOLOGY: A subgroup of 94 patients was retrospectively analysed from the TRIMPOL II study, a multicentre, double-blind randomised placebo-controlled trial in 426 patients with stable effort angina...
September 2004: Current Medical Research and Opinion
Hanna Szwed
In clinical practice there is a major problem with angina, which is resistant to medical therapy with hemodynamically acting agents. In that group of patients it is necessary to consider the indications for coronary angiography and percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass grafts (CABG). But some of these patients, especially those who had previous CABG or PTCA, coronary diabetic patients and elderly patients do not qualify for revascularization procedures. In patients with recurrent angina the beneficial effect of trimetazidine, a metabolic agent, that shifts cardiac energy metabolism from fatty acid oxidation to glucose oxidation was demonstrated...
May 2004: Coronary Artery Disease
H Szwed, Z Sadowski, W Elikowski, A Koronkiewicz, A Mamcarz, W Orszulak, E Skibińska, K Szymczak, J Swiatek, M Winter
AIMS: To assess the antiischaemic efficacy and tolerability of the metabolic agent trimetazidine in combination with metoprolol in patients with stable effort angina. METHODS: This was a randomized, multicentre, double-blind, placebo-controlled parallel group study. A total of 426 male and female patients with stable, effort-induced angina and documented coronary artery disease received either placebo or trimetazidine 20 mg three times daily in addition to metoprolol 50 mg twice daily...
December 2001: European Heart Journal
H Szwed, R Pachocki, M Domzal-Bochenska, K Szymczak, Z Szydlowski, A Paradowski, G Gajos, G Kaluza, I Kulon, A Wator-Brzezińska, W Elikowski, M Kuźniak
OBJECTIVE: Assess the antianginal and anti-ischemic effect of trimetazidine in patients with stable exercise-induced angina insufficiently controlled with conventional antianginal drugs. PATIENTS AND METHODS: The study population included patients with coronarographically documented stable exercise-induced angina and no other serious concomitant condition. For inclusion, patients had to have two comparably positive treadmill exercise tests. Conventional antiangina drugs (long-acting nitrate derivatives, beta-blockers or calcium antagonists) were continued as was any other therapy having no effect on the ECG ST segment...
March 18, 2000: La Presse Médicale
H Szwed, Z Sadowski, R Pachocki, M Domzał-Bocheńska, K Szymczak, Z Szydłowski, A Paradowski, G Gajos, G Kałuza, I Kulon, A Wator-Brzezińska, W Elikowski, M Kuźniak
Diabetes mellitus, a disease with a wide prevalence, has major cardiovascular effects, being a risk factor for the development of ischemic heart disease and congestive heart failure. The aim of this open, multicenter study was to assess the antiischemic efficacy and tolerability of trimetazidine, a metabolic agent acting at the myocardial mitochondrial level, in diabetic patients with stable effort angina treated previously with a single conventional antianginal drug. Fifty diabetic patients (mean age 58 years) with proven coronary artery disease, stable effort angina for at least 3 months, and positive, comparable results of two initial treadmill exercise tests separated by a 1-week interval were included in the study...
May 1999: Cardiovascular Drugs and Therapy
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