ORIGINAL ARTICLE   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2019 December;178(12):911-5

DOI: 10.23736/S0393-3660.18.03974-8

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Trimetazidine prolongs claudication distance in patients with peripheral arterial disease

Matija KOZAK ¹ ✉, Sara MUGERLI ², Borut JUG ¹

¹ Department for Vascular Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia; ² General Hospital dr. Franca Derganca, Nova Gorica, Slovenia

BACKGROUND: Intermittent claudication is a common manifestation in peripheral arterial atherosclerotic disease (PAD). Trimetazidine is a metabolic agent with proven anti-ischemic effects in the cardiac muscle. We wanted to assess the effect of trimetazidine as compared to pentoxifylline on pain-free walking distance in symptomatic patients.
METHODS: Stable PAD patients were included in a randomized, open-label, 2-treatment 2-period (2x2) cross-over trial. They were randomized to 4 weeks of trimetazidine (35 mg bid) followed by 4 weeks of pentoxifylline (600 mg bid), or the reversed sequence.
RESULTS: 20 patients (54-79 years) were included. Pain-free and maximal walking distance significantly increased in both groups: 31 m (P=0.002) and 54 m (P=0.001) with trimetazidine, and 32 m (P=0.002) and 27 m (P=0.008) with pentoxifylline, respectively. The difference was statistically not significant with respect to intervention period or intervention sequence.
CONCLUSIONS: Trimetazidine improves pain-free walking distance in symptomatic patients with PAD; the improvement is comparable to pentoxifylline.

KEY WORDS: Peripheral arterial disease; Intermittent claudication; Trimetazidine