Effectiveness of Trimetazidine in Patients with Stable Angina Pectoris of Various Durations: Results from ODA

Abstract

Introduction: Trimetazidine (TMZ) is an antianginal agent that acts directly at the myocardial cell level and which is now available in a once-daily (od) formulation.

Methods: ODA, a 3-month, observational, multicenter study in Russia, assessed the effectiveness and tolerability of TMZ 80 mg od in patients with stable angina and persisting symptoms, in real-life settings. The present analysis explored the effects of adding TMZ to background antianginal treatment with respect to the duration of stable angina.

Results: A total of 3032 patients were divided into four groups according to stable angina pectoris duration since diagnosis, ranging from less than 1 year to more than 10 years. A decrease in frequency of angina attacks was observed, including in patients with angina duration < 1 year, in whom the frequency of weekly angina attacks decreased from 3.8 ± 2.9 to 1.4 ± 1.7 at 1 month and 0.6 ± 1.0 at 3 months. Short-acting nitrate consumption and proportion of angina-free patients decreased, and self-reported physical activity and adherence to antianginal therapy improved in all patient groups, including recently diagnosed patients and starting already at month 1.

Conclusions: Addition of TMZ 80 mg od to antianginal treatment was effective in reducing the frequency of angina attacks and the use of short-acting nitrates, improving Canadian Cardiovascular Society (CCS) class, self-reported physical activity, and adherence to antianginal therapy. These beneficial effects were observed in patient groups with different durations of stable angina, suggesting an opportunity for decreasing angina burden even in recently diagnosed patients.

Trial registration: ISRCTN registry Identifier, ISRCTN97780949.

Keywords: Chronic coronary syndrome; Diagnosis duration; Observational study; Real-world evidence; Stable angina; Trimetazidine.

Fig. 1

Changes in mean weekly angina attacks

Fig. 2

Changes in number of short-acting nitrates taken per week

Fig. 3

Proportion of angina-free patients during the study

Fig. 4

The share of patients with no or slight physical limitation in group 1 and group 2 was already significantly increased at 1 M (p < 0.01 for no limitation and p < 0.001 for slight limitation increase). The share of patients with no or only a slight physical limitation increased progressively by M3 and in all groups regardless of the duration of the disease (p < 0.001)

Fig. 5

At M1 the share of patients with good adherence was significantly increased in patients of group 2, 3 and 4 (p < 0.001). By M3 the share of patients with good adherence was significantly increased in all groups, regardless of the duration (p < 0.001).