Abstract

Background: Trimetazidine, a cytoprotective agent, is better anti-ischemic drug than conventional agents without causing any change in heart rate and blood pressure.

Aims and Objectives: To compare the efficacy of trimetazidine with diltiazem in chronic stable angina.

Materials and Methods: Thirty diagnosed cases of chronic stable angina were subjected to TMT I with total effort duration and time to precipitate angina being the end point. Patients were given 60 mg of trimetazidine for 8 weeks, in addition to their conventional treatment and subjected to another TMT II with the same end points. After a washout period of 2 weeks, the same patients were put on diltiazem 60 mg TDS for 8 weeks again with another third TMT III to evaluate the results.

Results: The mean age of all patients was 57.70 ± 8.44. The mean increase in effort duration between TMT II (7.50 ± 1.52) and I (6.21 ± 1.65 min) was 1.29 min which was statistically significant (P < 0.001) while difference between TMT III (7.21 ± 1.56) and I (6.21 ± 1.65 min) was 1.0 min (P < 0.05 s). The difference observed between TMT III and II was 0.29 (P > 0.05 not significant). The increase in time to ST-segment depression between TMT I and II was 1.35 min. (P < 0.001), whereas the difference between TMT I and III was 1.01 min (P < 0.05 significant). Anginal attacks per week with diltiazem were 1.81 ± 0.59 and 1.67 ± 0.52 with trimetazidine (P > 0.005).

Conclusions: The patients with stable angina had a better clinical improvement after treatment with trimetazidine, without any adverse effects.

Key words: Stable Angina; Diltiazem; Trimetazidine; Metabolic Modulators; Cytoprotection