Additional Use of Trimetazidine in Patients With Chronic Heart Failure

Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital of Fudan University, Shanghai, China.
Journal of the American College of Cardiology (Impact Factor: 16.5). 03/2012; 59(10):913-22. DOI: 10.1016/j.jacc.2011.11.027
Source: PubMed


The aim of this meta-analysis was to evaluate the effects of additional trimetazidine (TMZ) treatment on patients with chronic heart failure (CHF).
Conflicting results currently exist on the clinical use of TMZ in CHF patients.
PubMed, MEDLINE, EMBASE, and EBM Reviews databases were searched through November 2010 for randomized controlled trials (RCTs) assessing TMZ treatment in CHF patients. Data concerning the study design, patient characteristics, and outcomes were extracted. Risk ratio (RR) and weighted mean differences (WMD) were calculated using fixed or random effects models.
Sixteen RCTs involving 884 CHF patients were included. Hospitalization for cardiac causes (RR: 0.43, p = 0.03), but not all-cause mortality (RR: 0.47, p = 0.27), was reduced by TMZ treatment. Moreover, TMZ therapy was associated not only with the increase of left ventricular ejection fraction (WMD: 6.46%, p < 0.0001) and total exercise time (WMD: 63.75 seconds, p < 0.0001), but also with the decrease of New York Heart Association functional class (WMD: -0.57, p = 0.0003), left ventricular end-systolic diameter (WMD: -6.67 mm, p < 0.0001), left ventricular end-diastolic diameter (WMD: -6.05 mm, p < 0.0001), and B-type natriuretic peptide (WMD: -203.40 pg/ml, p = 0.0002).
Additional use of TMZ in CHF patients may decrease hospitalization for cardiac causes, improve clinical symptoms and cardiac function, and simultaneously ameliorate left ventricular remodeling.

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    • "One year later, Zhang et al. [54] presented another meta-analysis on the use of trimetazidine in CHF patients. This time, 16 randomized studies were evaluated, with 884 patients in the study group. "
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    • "These trials investigated clinical symptoms, cardiac function, quality of life, hospitalization, mortality and cardiovascular events, comparing TMZ with placebo. In addition, two meta-analyses of RCTs have also been performed to assess the therapeutic effects of TMZ in CHF patients [7], [8]. However, some conclusions drawn from these two meta-analyses are not consistent. "
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