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Objective: To describe the anti-ischemic effectiveness of trimetazidine 80 mg once daily (TMZ OD) in outpatients with symptomatic stable coronary artery disease (CAD) and a history of myocardial infarction (MI) in real clinical practice. Design and method: The METHOD (NCT05210465) was a 6-month single-center observational study. Adult outpatients with symptomatic stable CAD and a history of MI who had been recommended to initiate TMZ OD in addition to the standard antianginal therapy were included. Myocardial ischemia was assessed by stress echocardiography (STE) in speackle tracking mode (STM). Primary outcome was the mean change in left ventricular global longitudinal strain (LV GLS) at visit 2 (∼ 6 months) compared to baseline (BL). Main secondary outcomes were mean changes in regional peak systolic deformation (RPSD), global post systolic index (PSI) and the number of anginal attacks per week. Data from patients who completed the study were analyzed. Results: Of 36 included patients, 41.7% (15/36) were female, mean age was 62.3 (±7.6) years. Mean time since CAD diagnosis and occurrence of MI was 4.5 (±5.3) and 2.9 (±3.4) years, respectively. Proportions of patients with diabetes, coronary percutaneous revascularization or hypertension were 30.6% (11/36), 88.9% (32/36) and 88,9 (32/36), respectively. Before initiation of TMZ OD, all patients had been taking beta-blockers (36/36), and 33.3% (12/36) calcium channel blockers. LV GLS was significantly improved by -2% (p <0,001) from -13.3% (3.6) at BL to -15.3% (3.7) at V2. There was a significant improvement in RPSD of apex (-1.2., p = 0,042), apical anterior (-2.6% p <0,001) and lateral (-1.5%, p= 0,032) segments of LV myocardium. Compared to BL, mean PSI was significantly changed from 33.3% to 28.9% (-4.3%, p=0,004) at V2. Angina frequency significantly decreased from 1.0 (1.4) to 0.1 (0.4) attacks per week (p<0.001). No adverse events were reported. Conclusions: Treatment with TMZ OD demonstrated significant decrease in myocardial ischemia and improvement in angina control in patients with CAD and a history of MI and was well tolerated.
Elyubaeva et al. (Wed,) studied this question.