Trimetazidine in Cardiovascular Disease and Beyond: A Comprehensive Review
Goel, Harsh Roma, Nicholas Morgan, Michael Arora, Riya Sreejith, Nayanika Goyal, Deepak Nadar, Sunil
Goel, Harsh
Roma, Nicholas
Morgan, Michael
Arora, Riya
Sreejith, Nayanika
Goyal, Deepak
Nadar, Sunil
Affiliation
St. Luke's University Hospital; Northwest Anglia Foundation NHS Trust; The Duldey Group NHS Foundation Trust et al
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Publication date
2025-04-03
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Abstract
Trimetazidine is a metabolic modulator that acts as a competitive inhibitor of the terminal enzyme in the ?-oxidation pathway to shift energy substrate from free fatty acids to the more oxygen-efficient glucose metabolism. The resulting conservation of cellular adenosine triphosphate generation in the face of ischemia/hypoxia mediates the anti-ischemic efficacy of trimetazidine. Clinically, trimetazidine has been approved as an add-on treatment in patients with symptomatic angina that is poorly controlled with first-line agents or who cannot tolerate the first-line therapy. In addition, trimetazidine has demonstrated antioxidant, cytoprotective, and anti-apoptotic activity with applications beyond angina. The aim of this review was to summarize the mechanism of action and anti-anginal efficacy of trimetazidine and to discuss the putative role of these pleiotropic effects and the evidence behind its application in cardiovascular diseases in general.
Citation
Goel H, Roma N, Morgan M, Arora R, Sreejith N, Goyal D, Nadar S. Trimetazidine in Cardiovascular Disease and Beyond: A Comprehensive Review. Am J Cardiovasc Drugs. 2025 Apr 3. doi: 10.1007/s40256-025-00724-1. Epub ahead of print