Gabriele Fragasso1, Giuseppe Rosano2, Sang Hong Baek3, Hamayak Sisakian4, Pericle Di Napoli5, Luca Alberti6, Giliola Calori6, Seok-Min Kang7, Laura Sahakyan4, Armen Sanosyan4, Cristiana Vitale2, Giuseppe Marazzi2, Alberto Margonato6, Romualdo Belardinelli8. 1. Heart Failure Unit, Istituto Scientifico Ospedale San Raffaele, Milano, Italy. Electronic address: gabriele.fragasso@hsr.it. 2. Department of Medical Sciences, IRCCS San Raffaele, Roma, Italy. 3. Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea. 4. Department of General and Invasive Cardiology, University Hospital 1, Yerevan State Medical University, Yerevan, Armenia. 5. SMDN, Center for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy. 6. Heart Failure Unit, Istituto Scientifico Ospedale San Raffaele, Milano, Italy. 7. Severance Hospital, Yonsei University, Seoul, South Korea. 8. Cardiac Rehabilitation, Cardiology Division "GM Lancisi", Azienda Ospedali Riuniti, Ancona, Italy.
Abstract
OBJECTIVES: The aim of this cohort study was to retrospectively evaluate, in patients with chronic heart failure (CHF), the long term effect of trimetazidine (TMZ) on morbidity and mortality. BACKGROUND: Previous small studies in patients with CHF have shown that TMZ can improve left ventricular function, exercise capacity and NYHA class compared to placebo. However, no data on the effects of TMZ on survival in patients with CHF have ever been produced. METHODS: In this international multicentre retrospective cohort study data from 669 patients were analyzed. 362 patients were on TMZ due to symptom persistence despite up-titration of optimal CHF therapy, while the remaining patients continued conventional CHF therapy alone. Propensity score analysis was performed in order to minimize selection bias between the two groups. RESULTS: Kaplan-Meier analysis for global mortality showed 11.3% improved global survival (p=0.015) and 8.5% improved survival for cardiovascular (CVD) death (p=0.050) in the TMZ group. Cox regression analysis for global mortality showed a significant risk reduction for TMZ treated patients with a hazard ratio (HR)=0.189 (confidence interval - CI 95%: 0.017-0.454; p=0.0002). TMZ also showed a good risk reduction profile for CVD death causes (HR=0.072, CI 95%: 0.019-0.268, p=0.0001). The rate of hospitalization for cardiovascular causes was reduced by 10.4% at 5 years (p<0.0005) with increased hospitalization-free survival of 7.8 months. CONCLUSION: TMZ is effective in reducing mortality and event-free survival in patients with CHF. The addition of TMZ on top of optimal medical therapy improves long term survival in CHF patients.
OBJECTIVES: The aim of this cohort study was to retrospectively evaluate, in patients with chronic heart failure (CHF), the long term effect of trimetazidine (TMZ) on morbidity and mortality. BACKGROUND: Previous small studies in patients with CHF have shown that TMZ can improve left ventricular function, exercise capacity and NYHA class compared to placebo. However, no data on the effects of TMZ on survival in patients with CHF have ever been produced. METHODS: In this international multicentre retrospective cohort study data from 669 patients were analyzed. 362 patients were on TMZ due to symptom persistence despite up-titration of optimal CHF therapy, while the remaining patients continued conventional CHF therapy alone. Propensity score analysis was performed in order to minimize selection bias between the two groups. RESULTS: Kaplan-Meier analysis for global mortality showed 11.3% improved global survival (p=0.015) and 8.5% improved survival for cardiovascular (CVD) death (p=0.050) in the TMZ group. Cox regression analysis for global mortality showed a significant risk reduction for TMZ treated patients with a hazard ratio (HR)=0.189 (confidence interval - CI 95%: 0.017-0.454; p=0.0002). TMZ also showed a good risk reduction profile for CVD death causes (HR=0.072, CI 95%: 0.019-0.268, p=0.0001). The rate of hospitalization for cardiovascular causes was reduced by 10.4% at 5 years (p<0.0005) with increased hospitalization-free survival of 7.8 months. CONCLUSION:TMZ is effective in reducing mortality and event-free survival in patients with CHF. The addition of TMZ on top of optimal medical therapy improves long term survival in CHFpatients.
Authors: Angelical S Martin; Dennis M Abraham; Kathleen A Hershberger; Dhaval P Bhatt; Lan Mao; Huaxia Cui; Juan Liu; Xiaojing Liu; Michael J Muehlbauer; Paul A Grimsrud; Jason W Locasale; R Mark Payne; Matthew D Hirschey Journal: JCI Insight Date: 2017-07-20
Authors: Yong Seon Choi; Ana Barbosa Marcondes de Mattos; Dan Shao; Tao Li; Miranda Nabben; Maengjo Kim; Wang Wang; Rong Tian; Stephen C Kolwicz Journal: J Mol Cell Cardiol Date: 2016-09-28 Impact factor: 5.000
Authors: Jeong Su Kim; Chang Hoon Kim; Kook Jin Chun; June Hong Kim; Yong Hyun Park; Jun Kim; Jin Hee Choi; Sang Hyun Lee; Eun Jung Kim; Dae Gon Yu; Eun Young Ahn; Myung Ho Jeong Journal: Clin Res Cardiol Date: 2013-08-28 Impact factor: 5.460