Trimetazidina en el tratamiento del angor estable

Álvaro Danza; Federico Cristiani; Gustavo Tamosiunas

Authors

Álvaro Danza Universidad de la República, Facultad de Medicina, Departamento de Farmacología y Terapéutica. Departamento Clínico de Medicina. Farmacología y Terapéutica, Asistente. Clínica Médica "A", Ex Residente
Federico Cristiani Universidad de la República, Facultad de Medicina, Departamento de Farmacología y Terapéutica, Farmacología y Terapéutica, Ayudante. Practicante Interno
Gustavo Tamosiunas Universidad de la República, Facultad de Medicina, Farmacología y Terapéutica. Departamento de Farmacología y Terapéutica, Profesor Agregado. Especialista en Cardiología y en Farmacología y Terapéutica

Keywords:

ANGINA PECTORIS, TRIMETAZIDINE, DRUG EVALUATION

Abstract

Introduction: ischaemic cardipathy is a highly prevalent disease in our country. It is caused by an imbalance between the oxygen requirement of the myocardium and the oxygen supplied to it. Conventional therapeutics focuses on modification of hemodynamics variables. However, a significant number of patients still evidenced symptoms after applying these therapeutics. Thus, new ways of drug (non-hemodynamic) interventions are being sought, such as metabolic kinds of intervention, by increasing myocardial energy substrates yield. Trimetazidine is a drug that acts by modulating myocardial metabolism, proving to be a new and promising action mechanism.
Objective: to update and perform a critical analysis of the information on the efficacy and safety of trimetazidine in treating stable angina pectoris that is currently available, thus learning about its usefulness in clinical practice and encouraging its rational use.
Method: Medline, Lilacs and Cochrane Databases were searched, looking for information. To learn about its efficacy, controlled clinical trials, systematic reviews and meta-analysis were included. To learn about safety, notifications, series of cases and drug surveillance bulletins were also integrated.
Results: studies conducted showed symptomatic improvement with trimetazidine, with no notifications of serious adverse effects, although elderly patients evidenced extrapyramidal symptoms.
Conclusions: trimetazidine has been shown to improve symptoms in patients with stable angina pectoris. There is no information about its effects on "hard" variables such as mortality or myocardial infarction. As with all new drugs, active safety surveillance is advised.

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