A randomised clinical trial conducted in patients who had undergone successful percutaneous coronary intervention (PCI) showed that the routine use of oral trimetazidine does not reduce cardiac events in patients receiving optimal medical therapy, according to an article published in Lancet.
The analysis included 6,007 patients who had undergone successful PCI, randomly assigned to receive trimetazidine 35 mg modified-release twice daily (n=2,998) or placebo (n=3,009) added to standard background therapy. The primary efficacy endpoint was a composite of cardiac death, hospital admission for a cardiac event, recurrence or persistence of angina, or recurrence/persistence of angina requiring coronary angiography.
The results show that compared with placebo, trimetazidine did not improve the primary composite efficacy endpoint during a median follow-up of 47.5 months. When analysed individually, there were no significant differences in the incidence of the components of the primary endpoint between the treatment groups. The researchers also found that long-term use of trimetazidine was not associated with any safety issues.
The authors conclude that the prophylactic use of trimetazidine added to guideline-recommended medical therapy did not improve the outcomes of patients after a successful elective or urgent PCI.