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Review paper

The role of metabolic therapy with trimetazidine in effort tolerance in patients with ischemic heart disease

By
Una Suljić ,
Una Suljić

School of Pharmacy, University Tuzla, Tuzla, Bosnia and Herzegovina

Besim Prnjavorac Orcid logo ,
Besim Prnjavorac
Contact Besim Prnjavorac

General Hospital, Tešanj, Tešanj, Bosnia and Herzegovina

School of Pharmacy, University Sarajevo, Sarajevo, Bosnia and Herzegovina

School of Medicine, University Zenica, Zenica, Bosnia and Herzegovina

School of Medicine, School of Science and Technology (SSST) Sarajevo, Sarajevo, Bosnia and Herzegovina

Tamer Bego ,
Tamer Bego

School of Pharmacy, University Sarajevo, Sarajevo, Bosnia and Herzegovina

Maja Malenica ,
Maja Malenica

School of Pharmacy, University Sarajevo, Sarajevo, Bosnia and Herzegovina

Tanja Dujić ,
Tanja Dujić

School of Pharmacy, University Sarajevo, Sarajevo, Bosnia and Herzegovina

Irfan Prnjavorac ,
Irfan Prnjavorac

General Hospital, Tešanj, Tešanj, Bosnia and Herzegovina

Adlija Čaušević ,
Adlija Čaušević

School of Pharmacy, University Sarajevo, Sarajevo, Bosnia and Herzegovina

Lejla Šaranović
Lejla Šaranović

School of Medicine, University Zenica, Zenica, Bosnia and Herzegovina

Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Abstract

Aim
To investigate whether or not additional treatment of ischemic heart disease with trimetazidine could improve effort tolerance and overall quality of life of patients with ischemic heart disease.
Methods
The study included 200 patients with ischemic heart disease. The sample was divided into 2 randomly selected groups: experimental and control group. The diagnostic procedures included: trade-mill test according to Bruce protocol, heart ultrasound for assessment of ejection fraction, test for the assessment of quality of life and subjective problems (Short Form SF 36). Patients were tested for time of discharge from hospital, after 6 and 12 months, including re-evaluation of the overall condition of the previous period.
Results
Patients have been tested for the tolerance of effort with the measurement Metabolic Equivalent of TASK (METs), which is the equivalent of physical labor. Patients treated with trimetazidine since the time of hospital discharge achieved an average of 3.68, after 6 months 5.68, and after 12 months 7.79 METs. The control group achieved 3.68, 3.59 and 3.87 METs, respectively. Using Mann-Whitney test no difference at discharge time (p=0.880), but after six and twelve months there was some difference (p<0.001). Results of ejection fraction measured by echocardiography were similar. No difference between the two groups with regard to time of discharge (p=0.821, but p<0.001 after six and twelve months, respectively).
Conclusion
Patients treated with conventional therapy including trimetazidine have better tolerance to effort and better ejection fraction on heart ultrasound examination in comparison with those treated without trimetazidine, so trimetazidin improve the metabolic balance of heart muscle.

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