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Improving survival in symptomatic ischemic patients with left ventricular dysfunction Beneficial effects of long-term t

Presented at AHA 2012. Improving survival in symptomatic ischemic patients with left ventricular dysfunction Beneficial effects of long-term trimetazidine* therapy.

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Improving survival in symptomatic ischemic patients with left ventricular dysfunction Beneficial effects of long-term t

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  1. Presented at AHA 2012 Improving survivalin symptomatic ischemic patients with left ventricular dysfunctionBeneficial effects oflong-term trimetazidine* therapy *Trimetazidine is indicated by the European Medecines Agency (EMA) as add-on therapy for the symptomatic treatment of patients with stable angina pectoris who are inadequately controlled by or intolerant to first-line antianginal therapies. Fragasso G et al. Int J Cardiol. In press.

  2. What do preliminary data say? 2006 El-Kady Study Fragasso Study Di Napoli Study METRO Study Gao meta-analysis Zhang meta-analysis 2006 2007 2009 2011 2012 2005 n=200 Angina patients with ischemic left ventricular dysfunction n=65 Patients with heart failure n=61 Patients with severe ischemic cardiomyopathy n=353 Angina patients with acute myocardial infarction n=955 Heart failure patients n=884 Heart failure patients => First meta-analysis demonstrating mortality results => First results on mortality in a small population => Complemen-tary results on mortality in a small population => Primary objective was to assess the 6-month survival rate => First data on mortality evaluated as a safety parameter A study with a homogeneous and relevantly sized population is needed. n=number of patients. El Kady T et al. Am J Cardiovasc Drugs. 2005;5:271-278. Di Napoli P et al. J Cardiovasc Pharmacol. 2007;50:585-589. Fragasso et al. J Am CollCardiol. 2006;48:992-998. Iyengar S et al. Am J Cardiovasc Drugs. 2009;9:293-297. Gao D et al. Heart. 2011;97(4):278-286. Zhang L et al. J Am Coll Cardiol. 2012;59:913-922. Kim J et al. WCC 2012. Abstract 1621.

  3. A new study designed to evaluate survival 669 Symptomatic heart failure patients • International multicenter retrospective cohort study • Inclusion criteria: • Ejection fraction ≤ 45% • NYHA Class II-IV • Trimetazidine (TMZ) administered if symptoms persist despite correct titration of standard medical therapy for chronic heart failure (CHF) • CHF was of ischemicorigin in >80% of patients • Mean follow-up: 3 years • Propensity score Fragasso G et al. Int J Cardiol. In press.

  4. TMZ improves survival Event-free survival Global survival TMZ significantly improves global survival by 11.3% (P=0.015). Fragasso G et al. Int J Cardiol. In press.

  5. TMZ reduces global and cardiovascular mortality Heart failure patients live longer with TMZ. Fragasso G et al. Int J Cardiol. In press.

  6. TMZ reduces rate of hospitalizationfor cardiovascular causes Heart failure patients live better with TMZ. Fragasso G et al. Int J Cardiol. In press.

  7. Conclusion: • The addition of TMZ to standard medical therapy in patients with CHF significantly reduces total and cardiovascular mortality and improves event-free survival. • Therefore, this study confirms in a homogeneous and relevantly sized population that TMZ should be considered as a potential additional medication to standard therapy in CHF patients. • These results could be explained by the ability of TMZ to reduce ischemia whatever the causal mechanism, and therefore to protect the heart from subsequent damage. Fragasso G et al. Int J Cardiol. In press.

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