Dézsi Csaba A
Department of Cardiology, Petz Aladár County Teaching Hospital, Győr, Hungary.
Am J Ther. 2016 May-Jun;23(3):e871-9. doi: 10.1097/MJT.0000000000000180.
All of the following traditional agents for the management of stable angina pectoris include the symptomatic treatment with heart rate-lowering agents such as β-blockers or non-dihydropyridine Ca-channel blockers, or ivabradine-the first selective sinus node If channel inhibitor-vasodilatators and preventive use of angiotensin-converting enzyme inhibitors affect the parameters of circulation directly. Trimetazidine exerts its anti-ischemic action by modulating cardiac metabolism without altering the hemodynamic functions, therefore represents an excellent complementary potential to the conventional angina treatment. It has a beneficial effect on the inflammatory profile and endothelial function and shows diverse benefits by reducing the number and the intensity of angina attacks and improving the clinical signs and symptoms of myocardial ischemia given as monotherapy as well as combined with other antianginal agents. Patients undergoing coronary revascularization procedures or with comorbid left ventricular dysfunction and diabetes mellitus also benefit from the protective effects of trimetazidine.
以下所有用于稳定型心绞痛管理的传统药物，包括使用β受体阻滞剂或非二氢吡啶类钙通道阻滞剂等降低心率药物进行症状治疗，或伊伐布雷定（首个选择性窦房结If通道抑制剂）、血管扩张剂，以及预防性使用血管紧张素转换酶抑制剂，这些都会直接影响循环参数。曲美他嗪通过调节心脏代谢发挥抗缺血作用，而不改变血流动力学功能，因此是传统心绞痛治疗的极佳补充。它对炎症状态和内皮功能有有益影响，无论是作为单一疗法还是与其他抗心绞痛药物联合使用，通过减少心绞痛发作的次数和强度以及改善心肌缺血的临床体征和症状，都显示出多种益处。接受冠状动脉血运重建手术的患者或合并左心室功能障碍和糖尿病的患者也能从曲美他嗪的保护作用中获益。
