Trimetazidine 1(2, 3, 4 trimethoxybenzyl)-piperazine dihydrochloride has shown improved exercise tolerance and delayed ischemic threshold in patients with effort angina. But, unlike other classical antianginal drugs, it netiher reduces oxygen consumption nor increases the blood supply. Its effects could be attributed to protection of the myocardial cell function during ischemia, preventing the fall of ATP, reducing intracellular acidosis and subsequently preventing the accumulation of sodium and calcium in the myocyte.

We investigated the antianginal efficacy of trimetazidine(Vastinan) in 36 patients(22 males, 14 females, mean age of 56.5 year) who had positive exercise stress test among those with typical effort anginal symptoms from Feb, 1992 to Oct, 1992. These patients received 60mg trimetazidine per day(20mg tid) for 1 month and then exercise stress test, routine hematologic examination and urinalysis were performed at the beginning and at the end of therapeutic examination and urinalysis were performed at the beginning and at the end of therapeutic period. The results were as follows.

In exercise parameters, there were 19.2% increase in total work, 30.3% increase in exercise duration and 13% shortening in the normalization time of depressed ST-segment and these were no significant change in hemodynamic parameters(heart rate, blood pressure and maximum Rpp(rate pressure product)(p>0.05). The characters of chest pain were changed in the 19 patients, complete disappearance in 4 patients, reduction of intensity or frequency in 12 patients and aggravation in 3 patients. 2 patients complained of mild epigastric discomfort. There were no significant changes in hematologic findings and urinalysis.

Trimetazidine 60mg per day was efficient in patients with angina and more observations are necessary in assessing the long-term therapeutic efficacy and side effects of this drug.