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曲美他嗪对不同病程稳定型心绞痛患者的疗效:ODA研究结果

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

作者信息

Glezer Maria G, Vygodin Vladimir A

机构信息

Department of Cardiology, Functional and Ultrasonic Diagnostics, Sechenov First Moscow State Medical University, Moscow, Russia.

Laboratory of Biostatistics, National Medical Research Center for Preventive Medicine of the Ministry of Healthcare, Moscow, Russia.

出版信息

Cardiol Ther. 2020 Dec;9(2):395-408. doi: 10.1007/s40119-020-00174-7. Epub 2020 May 19.

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.

摘要

引言

曲美他嗪(TMZ)是一种抗心绞痛药物,直接作用于心肌细胞水平,目前有每日一次(od)的剂型。

方法

ODA是一项在俄罗斯进行的为期3个月的观察性多中心研究,在现实生活环境中评估了每日80毫克曲美他嗪对稳定型心绞痛且症状持续的患者的有效性和耐受性。本分析探讨了在背景抗心绞痛治疗中添加曲美他嗪对稳定型心绞痛持续时间的影响。

结果

根据自诊断以来稳定型心绞痛的持续时间,共3032例患者被分为四组,持续时间从不到1年到超过10年不等。观察到心绞痛发作频率降低,包括心绞痛持续时间<1年的患者,其中每周心绞痛发作频率在1个月时从3.8±2.9降至1.4±1.7,在3个月时降至0.6±1.0。所有患者组,包括近期诊断的患者且从第1个月就开始,短效硝酸盐的消耗量和无心绞痛患者的比例均下降,自我报告的体力活动和抗心绞痛治疗的依从性得到改善。

结论

在抗心绞痛治疗中添加每日80毫克曲美他嗪可有效降低心绞痛发作频率和短效硝酸盐的使用,改善加拿大心血管学会(CCS)分级、自我报告的体力活动以及抗心绞痛治疗的依从性。在不同稳定型心绞痛持续时间的患者组中均观察到这些有益效果,这表明即使在近期诊断的患者中也有减轻心绞痛负担的机会。

试验注册

ISRCTN注册标识符,ISRCTN97780949。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5f49/7584693/6fd17b65ba11/40119_2020_174_Fig1_HTML.jpg

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