Impact Of Trimetazidine On Exercise Performance In Stable Angina Pectoris Patients With Different Glucose Metabolism

ObjectiveTo assess the efficacy of trimetazidine (TMZ) on patients diagnosed as Stable Angina Pectoris (SAP) with different glucose glycometabolism,and datas like metabolic equivalents,total exercise time,ST segment changes,rate-pressure product,angina pectoris,and blood glucose level were measured in this study.Method1. Patients diagnosed as SAP were recruited and divided into impaired glucose tolerance group (IGT) and normal glucose tolerance group (NGT) according to oral glucose tolerance test (OGTT).2. Both groups were given combination of conventional antiangial agents added to trimetazidine (TMZ,20mg tid) for 4 weeks as treatment.Electrocardiogram treadmill exercise test(ETT) and OGTT were conducted at baseline and after 4 weeks.3. Metabolic equivalents,total exercise time,ST segment changes,angina episodes and blood glucose were measured at baseline and after 4 weeks.Result1.ETT data①Metabolic equivalents was increased both within the two groups with a statistical significance(P<0.01);the difference between the two groups had statistical significance,NGT group did better than the IGT group(1.66±0.46 vs 1.45±0.35 METs,P<0.05).②Total exercise time was improved both within the two groups with a statistical significance(P<0.01);the difference between the two groups had statistical significance,NGT group did better than the IGT group(87.54±42.94 vs 70.34±19.36s,P<0.05).③Time to 1-mm ST-segment depression was improved both within the two groups with a statistical significance(P<0.01);the difference between the two groups had statistical significance,NGT group did better than the IGT group(45.22±5.61 vs 31.25±7.07s,P<0.01).④The recovery time of ST segment was decreased both within the two groups with a statistical significance(P<0.01);the difference between the two groups had statistical significance,NGT group did better than the IGT group(48.37±22.16 vs 33.71± 20.38s,P<0.01).⑤Maximal ST segment depression was attenuated both within the two groups with a statistical significance(P<0.01);while no difference was observed between the two groups(P>0.05).⑥RPP stayed the same level after 4 weeks’ intervention,difference did not shown both within the two groups(P>0.05).2. Angina episode① Exercise induced angina was decreased both within the two groups with a statistical significance(P<0.05);the difference between the two groups had no statistical significance(P>0.05).②Nitroglycerin consumption and weekly angina attacks were decreased both within the two groups with a statistical significance(P<0.01);while no difference was observed between the two groups(P>0.05).③CCS classification was improved both within the two groups but difference was not shown between the two groups after 4 weeks(P>0.05).3. Blood glucose levelBoth within the two groups,the statastics did not show any diferences in fasting blood glucose(P>0.05),but postprandial 2 hours of blood sugar decreased in the IGT group (P<0.01),while not in the NGT group(P>0.05).Conclusion1. TMZ can improve the IGT group and the NGT group with metabolic equivalent,total exercise time,time to ST segment depression,shorten the recovery time of ST segment;NGT group did better than IGT group.2. TMZ can improve the clinical situation of angina pectoris both within the two groups,while there was no difference between them.