Abstract 1598: Trimetazidine Reduces Mortality And Hospitalization In Patients With Ischemic Cardiomyopathy: A 4-year Follow-up Post-hoc Analysis.
Aims: to determine the effects of trimetazidine on all-cause mortality and heart failure hospitalizations in patients with ischemic cardiomyopathy.
Methods: we performed an extension to 48 months and a post-hoc analysis of the Villa Pini d’Abruzzo trimetazidine trial; in this single centre, open-label, randomized trial with the metabolic inhibitor trimetazidine in chronic heart failure, sixty-one patients were randomized to either receive trimetazidine (20mg tid) in addition to their conventional treatment or to continue their usual drug therapy for 4 years. Patients were evaluated at baseline, 6, 12, 18, 24, 32, 36, 42 and 48 months with clinical examination, echocardiography and six-minutes walking test.
Results: trimetazidine added to the usual treatment significantly reduces all-cause mortality (−56%, hazard ratio 0.258, 95% CI 0.097 – 0.687; log-rank test p = 0.0047), heart failure hospitalization (−47%, log-rank test p= 0.002), and improves patient functional status (NYHA class and 6-min walking test). In trimetazidine-treated patients a significant increase of the Left Ventricle Ejection Fraction was also detected (LVEF p<0.001 at 48 months).
Conclusion: long-term trimetazidine significantly reduces all-cause mortality and heart failure hospitalization in patients with ischemic cardiomyopathy.