Trimetazidine improves left ventricular function in diabetic patients with coronary artery disease: a double-blind placebo-controlled study
Why the study?
Does trimetazidine improve left ventricular function in patients with type 2 diabetes and ischemic cardiomyopathy?
Population
32 patients with type 2 diabetes and ischemic cardiomyopathy, mean age 67 +/- 6 years, 24 males and 8 females.
Comparison
Trimetazidine 20 mg t.d.s. added to standard… vs Placebo t.d.s. added to standard medical therapy…
Design
RCT, randomized parallel study, double-blind, placebo-controlled
Follow-up
6 months
Authors
Discussion
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Implication
Trimetazidine may improve LV function when added to standard therapy in diabetic ischemic cardiomyopathy; extends metabolic modulation evidence in this population.
Key Points
- To evaluate the effect of the metabolic agent trimetazidine on left ventricular function in patients with diabetic ischemic cardiomyopathy.
- Randomized, double-blind, parallel-group placebo-controlled trial including 32 patients (24 males and 8 females; mean age 67 ± 6 years) with type 2 diabetes and ischemic cardiomyopathy.
- Participants received either trimetazidine (20 mg three times daily) or placebo three times daily for six months.
- Echocardiographic evaluations were performed at baseline and after six months of treatment.
- Left ventricular end-diastolic diameter decreased from 63.2 ± 2.1 mm to 58 ± 1.6 mm (p < 0.01 compared to baseline) in the trimetazidine group, while increasing from 62.4 ± 1.7 mm to 63 ± 2.1 mm in the placebo group.
- Left ventricular ejection fraction increased by 5.4 ± 0.5% (p < 0.05 compared to baseline) with trimetazidine versus a non-significant change of -2.4 ± 1.1% with placebo (p < 0.01 between groups).
- Significant improvements in the wall motion score index and the E/A wave ratio were observed in the trimetazidine group but not in the placebo group.
Structured PICO
Does trimetazidine improve left ventricular function in patients with type 2 diabetes and ischemic cardiomyopathy?
P
Population
32 patients with type 2 diabetes and ischemic cardiomyopathy, mean age 67 +/- 6 years, 24 males and 8 females.
I
Intervention
Trimetazidine 20 mg t.d.s. (three times a day) added to standard medical therapy for 6 months.
C
Comparator
Placebo t.d.s. added to standard medical therapy for 6 months.
O
Outcome
Left ventricular function (left ventricular end-diastolic diameter and left ventricular ejection fraction) at 6 months.surrogate
In diabetic patients with ischemic cardiomyopathy, trimetazidine added to standard medical therapy significantly improves left ventricular ejection fraction and volumes.
Cite This Study
Rosano et al. (2003) studied this question.