Trimetazidine combined with metoprolol improves therapeutic outcomes in patients with coronary heart disease complicated by heart failure

OBJECTIVE: To investigate the therapeutic efficacy and influencing factors of metoprolol combined with trimetazidine in the treatment of heart failure secondary to coronary heart disease (CHD). METHODS: A retrospective analysis was performed on 142 patients with CHD complicated by heart failure (HF) who were treated at the First Affiliated Hospital of Xinjiang Medical University from July 2023 to July 2025. Patients were allocated into a control group (trimetazidine monotherapy, n=70) and a joint group (metoprolol combined with trimetazidine, n=72). Clinical outcomes were compared between the two groups, including overall treatment efficacy, QT dispersion (QTd) before and after treatment, heart rate (HR), hemodynamic parameters [hematocrit (Hct), plasma fibrinogen (Fib), plasma specific viscosity], vascular endothelial function markers [calcitonin gene-related peptide (CGRP), plasma endothelin (ET), nitric oxide (NO)], cardiac function indicators [left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESD)], and incidence of adverse reactions. Logistic multivariate regression analysis was performed to identify independent factors affecting therapeutic efficacy in CHD patients complicated by HF. RESULTS: The total effective rate was significantly higher in the joint group than the control group (86.11% vs. 71.43%, P=0.032). After treatment, QTd, HR, ET, and hemodynamic parameters were significantly decreased in both groups compared with baseline, whereas CGRP, NO, and LVEF were significantly increased. Moreover, the improvement in the joint group was significantly superior to that in the control group (P<0.05). There was no significant difference in the overall incidence of adverse reactions between the two groups (13.89% vs. 12.86%, P=0.857). Multivariate logistic regression analysis identified treatment regimen, diabetes mellitus, and age as independent factors affecting therapeutic efficacy (P<0.05). CONCLUSION: Trimetazidine combined with metoprolol demonstrates superior efficacy without increasing adverse reactions in CHD patients complicated by HF. This combination therapy may improve hemodynamic status, endothelial function, and cardiac function, supporting its clinical application.