Trimetazidine(Vastinan®) is a new antianginal agent of different action mechanism specifically targeted at the metabolic cellular consequences of myocardial ischemia. The clinical efficacy of the Trimetazidine in angina pectoris is still to be defined.

To determine the antianginal effect of trimetazidine in the treatment of ischemic heart disease, 15 patients with stable angina(12 male, 3 female, mean age : 59.3 years) were studied. In 6 cases as a single agent and in 9 cases as an additive regimen to conventional antianginal medications. Trimetazidine(20mg 3 times daily) was given for 30 days or more to evaluate the clinical effect. Graded exercise tests were carried out before the trial of Trimetazidine and on the 30th day of the treatment period.

1) The number of episodes of anginal attacks decreased from 4.2±2.7 to 2.0±0.5 a week(p<0.05) after treatment with Trimetazidine. 2) Trimetazidine also significantly increased the duration of total exercise from 12.1±4.7 min to 14.5±3.3 min(p<0.05), and the time to 1mm ST segment depression from 7.7±5.9 min to 11.7±5.2 min(p<0.05) on treadmill exercise by modified Bruce protocol. 3) Total workload (METs) and rate pressure double product(heart rate x systolic blood pressure) slightly increased, but the differences were not significant statistically. 4) No serious clinical side effects were observed during the treatment.

These results suggest that the Trimetazidine is an effective and safe as an antianginal drug in the treatment of stable angina patients as a single agent and as an additive regimen when the patients are refractory to conventional drugs.