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XU X et al. Clin Drug Investig (2014) 34:251–258

Can we improve the management of angina patients after percutaneous coronary intervention ? Beneficial effects of adding trimetazidine MR therapy after PCI in multivessel coronary heart disease patients with diabetes mellitus. PCI: percutaneous coronary intervention.

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XU X et al. Clin Drug Investig (2014) 34:251–258

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  1. Can we improvethe management of angina patients after percutaneous coronary intervention?Beneficial effects of adding trimetazidine MR therapyafter PCI in multivessel coronary heart disease patients with diabetes mellitus PCI: percutaneous coronary intervention XU X et al. Clin Drug Investig (2014) 34:251–258

  2. Treating angina by exclusively targetingcoronary obstruction is insufficient Boden et al. (COURAGE Study). N Engl J Med. 2007;356:1503-1516.

  3. Beneficial effects of trimetazidine therapyin CHD patients after PCI • Methods • 700 coronary heart disease (CHD) patients with diabetes mellitus (DM) who were aged 65 years and undergoing coronary angiography were randomized. • Half of them received trimetazidine 20 mg three times daily after stent implantation as an addition to conventional CHD treatment. The other half received conventional treatment alone (approx. 70% of patients were taking -blockers). • Primary end point: • Incidence of recurrent angina pectoris • measures of various echocardiographic parameters. XU X et al. Clin Drug Investig (2014) 34:251–258

  4. Beneficial effects of trimetazidine therapyin CHD patients after PCI Results Compared with the control group, trimetazidine significantly reduced recurrent angina pectoris (P=0.010) and silent myocardial ischemia (P=0.009). XU X et al. Clin Drug Investig (2014) 34:251–258

  5. Beneficial effects of trimetazidine therapyin CHD patients after PCI Results Left ventricular function and left ventricular structure were both relatively stable in trimetazidine-treated patients after 2 years of follow-up, while they deteriorated in the control group with a significant difference between groups (all P<0.01). XU X et al. Clin Drug Investig (2014) 34:251–258

  6. Beneficial effects of trimetazidine therapyin CHD patients after PCI Results Independent predictors of recurrent angina pectoris in the 2 years following PCI included three-vessel disease, current smoking, BMI, and history of hypertension and hypercholesterolemia, while trimetazidine treatment had a beneficial effect. Trimetazidine: a predictor of protection XU X et al. Clin Drug Investig (2014) 34:251–258

  7. Beneficial effects of trimetazidine therapyin CHD patients after PCI Discussion XU X et al. Clin Drug Investig (2014) 34:251–258

  8. Conclusion • About one-third of patients still have angina after myocardial revascularization. • Trimetazidine effectively reduces recurrent angina and preserves left ventricular function in patients with multivessel CHD and DM. • These benefits could be linked to the mode of action of trimetazidine MR. By directly providing a 33% increase in the energy supplied to the cardiac cells, trimetazidineMR effectively reduces angina and provides unique cardioprotective benefits.

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