Abstract 14057: Both Trimetizidine and Ranolazine Improve Arterial Vasoreactivity in Patients With Ischemic Heart Disease
Introduction: Endothelium-dependent and independent vasodilator dysfunction are independent predictors of disease progression of atherosclerosis and rates of cardiovascular events in patients with ischemic heart disease. Ranolazine and trimetazidine are novel drugs that reduce angina symptoms in patients with ischemic heart disease. The aim of this study was to compare the effects of ranolazine and trimetazidine on endothelium dependent and independent arterial dilation.
Design: In a prospective, double blind study, 52 males aged between 18 to 65 years with chronic ischemic heart disease were randomised and submitted to 12 weeks treatment with either trimetazidine (35 mg twice daily) or ranolazine. Ranolazine was given in a dose of 375 mg twice daily for 4 weeks and was increased to 500 mg twice daily. Flow-mediated (endothelium-dependent) dilation (FMD) and nitroglycerin-induced (endothelium-independent) (GTN) dilation of brachial artery were measured using high resolution ultrasound.
Results: FMD increased from 3.5±7.4 to 13.8±9.4% (p<0.013) in the trimetazidine group, and from 2.4±4.3 to 9.5±7.7% (p<0.037) in the ranolazine group, with no difference between the groups (p=0.444). GTN increased from 16.1±9.2 to 21.2±19.3% (p<0.022) and from 13.8±9.6 to 21.7±13.7% (p<0.006), respectively, with no difference between the groups (p=0.309). FMD/GTN ratio increased in trimetazidine group from 0.217±0.234 to 0.651±0.442 (p=0.031) and from 0.152±0.183 to 0.438±0.463 (p=0.098) in ranolazine group, the improvement being significantly better after trimetazidine (p=0.046).
Conclusions: Both trimetizedine and ranolazine lead to an improvement of endothelium-dependent and endothelium-independent dilation of brachial artery in the patients with ischemic heart disease. Due to greater increase of FMD/GTN ratio, we can assume that trimetazidine has more benefical effect on endothelium than ranolazine.
Author Disclosures: M. Šebeštjen: None. A. Rehberger-Likozar: None. B. Vrtovec: None. G. Poglajen: None.
- © 2014 by American Heart Association, Inc.