| Definition | Trimetazidine is a piperazine derivative indicated for the symptomatic treatment of stable angina pectoris in patients inadequately controlled or intolerant to first line therapies.[L33015] Trimetazidine has been studied as a treatment for angina pectoris since the late 1960s.[A233255,A233260]
Acidic conditions, caused by anaerobic metabolism and fatty acid oxidation, in response to myocardial ischemia, activate sodium-hydrogen and sodium-calcium antiport systems.[A233215] The increased intracellular calcium decreases contractility.[A233215] It is hypothesized that trimetazidine inhibits 3-ketoacyl coenzyme A thiolase, which decreases fatty acid oxidation but not glucose metabolism, preventing the acidic conditions that exacerbate ischemic injury.[A7688,L33020] However, evidence for this mechanism is controversial.[A233215]
Trimetazidine is not FDA approved. However, it has been approved in France since 1978.[L33020] |
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