Real-world Evidence for the Antianginal Efficacy of Trimetazidine from the Russian Observational CHOICE-2 StudyReportar como inadecuado

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Advances in Therapy

, Volume 34, Issue 4, pp 915–924

First Online: 20 February 2017Received: 21 October 2016DOI: 10.1007-s12325-017-0490-2

Cite this article as: Glezer, M. & On behalf of the CHOICE-2 study investigators Adv Ther 2017 34: 915. doi:10.1007-s12325-017-0490-2


IntroductionThe guidelines recommend a beta-blocker or calcium channel blocker as the first-line medication for angina, supplemented by other agents for additional symptoms. One such agent is trimetazidine TMZ, which has been shown to reduce the frequency of anginal episodes and improve exercise performance without affecting haemodynamic parameters. However, extensive real-world evidence for its efficacy in combination with first-line therapies has been lacking.

MethodsThe aim of this large-scale, Russian, multicentre, 6-month, open-label, prospective observational study was to assess the effect of adding TMZ modified release 35 mg bid to background antianginal therapy in the real-world clinical setting.

ResultsThe study included 896 patients: 54% women, aged 29–90 years 42.6% >65 years, 63% with class II angina, and receiving beta-blockers alone or in combination 93%. Add-on TMZ reduced angina frequency and short-acting nitrate use within 2 weeks both p < 0.0001 regardless of background therapy and maintained this effect over 6 months. It increased the proportion of patients with class I angina sixfold while decreasing that of class 3 angina almost fourfold. It also improved walking distance and well-being at 6 months both p < 0.0001. Treatment was well tolerated.

ConclusionAdd-on TMZ is a safe and rapidly effective treatment for reducing angina attacks and nitrate use in the real-world clinical setting. It also increases exercise capacity and well-being. These effects are observed within 2 weeks and persist for at least 6 months.

KeywordsAntianginal combination therapy Beta-blocker treatment Clinical practice Observational study Real-world evidence Stable angina Trimetazidine Enhanced contentTo view enhanced content for this article go to

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Autor: Maria Glezer - On behalf of the CHOICE-2 study investigators



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