[Therapeutic importance of trimetazidine in ischemic pathology of the myocardium].

Trimetazidine heralds a new therapeutic class and a new concept in coronary disease: that of cellular anti-ischemic, i.e. agents optimizing myocardial uptake of residual oxygen and substrate supplies and ensuring long-term protection of the myocardium against the harmful effects of ischaemia. The anti-ischemic efficacy of trimetazidine evidenced in all experimental models studied, its original mode of action, high degree of selectivity and convenience in use explain that clinical studies consistently underscore the therapeutic benefit of trimetazidine, with the following characteristics: whatever the clinical situation, trimetazidine always results in a rapid and major improvement in clinical and ECG signs; the therapeutic benefit with trimetazidine appears rapidly; trimetazidine is the only effective first-line antianginal agent that can freely be combined or co-prescribed with other agents; trimetazidine improves the efficacy of co-prescribed antianginal agents, and allows their dosages to be reduced, thereby decreasing the incidence of side effects; trimetazidine has no known contraindications, a strong advantage for coronary patients in whom other therapies are potentially dangerous. Further research is in progress to determine the therapeutic value of trimetazidine in other situations, e.g. acute stage of myocardial infarction or other conditions calling for effective myocardial protection.