Treatment of unstable angina with trimetazidine

Objective To evaluate the clinical therapeutic effects of trimetazidine on the treatment of unstable angina (UA) as well as its effects on endothelin-1 level and complications of patients. Methods One hundred and twenty patients with UA were randomized into the trimetazidine group (n =60) and the control group (n =60), the trimetazidine group was subjected to treatment with 60 mg trimetazidine everyday for six months plus conventional treatment, and the clinical symptoms, changes in electrocardiogram, changes in the number of plasma circulating endothelial cells (CEC) and endothelin-1 level of the two groups were observed after treatment for four weeks; and the incidence rates of cardiac arrhythmias, cardiac failure, hospitalization due to angina, myocardial infarction and sudden death were also observed after treatment for six months. Results 1) The total effective rate of integrative clinical therapeutic effects in the trimetazidine group and the control group after treatment for four weeks were 86.7% and 68.3%, respectively (P<0.05), and the excellence rates were 36.7% and 15% (P<0.01) respectively; the total effective rates for the therapeutic effects in electrocardiogram were 66.7% and 46.7%, respectively (P<0.05), and the excellence rates were 30.0% and 11.7%, respectively (P<0.01). 2) The number of plasma CEC and endothelin-1 level of the two groups after treatment for four weeks significantly decreased (P<0.05), but the decreases in the trimetazidine group were even significant (P<0.01). 3) The incidence rates for cardiac arrhythmia in the trimetazidine group and the control group after treatment for six months were 10% and 20% (P<0.05), respectively, and the incidence rates for cardiac failure were 8.3% and 18.3%, respectively (P<0.05), and the incidence rates for hospitalization due to angina were 10% and 15%, and the incident rates for myocardial infarction were 3.3% and 13.3% respectively (P<0.05). Conclusion Trimetazidine can significantly improve the symptoms of UA and myocardial ischemia, reduce the damages to blood vessel endothelium and complications, and improve the prognosis.