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American Journal of Cardiovascular Drugs

, Volume 18, Issue 2, pp 117–127 | Cite as

Impact of Trimetazidine Treatment on 5-year Clinical Outcomes in Patients with Significant Coronary Artery Spasm: A Propensity Score Matching Study

  • Yong Hoon Kim
  • Ae-Young Her
  • Seung-Woon Rha
  • Byoung Geol Choi
  • Se Yeon Choi
  • Jae Kyeong Byun
  • Ahmed Mashaly
  • Yoonjee Park
  • Won Young Jang
  • Woohyeun Kim
  • Jah Yeon Choi
  • Eun Jin Park
  • Jin Oh Na
  • Cheol Ung Choi
  • Hong Euy Lim
  • Eung Ju Kim
  • Chang Gyu Park
  • Hong Seog Seo
  • Dong Joo Oh
Original Research Article

Abstract

Objective

We aimed to evaluate the additive benefit of trimetazidine with well-known antispasmodic agents such as calcium channel blockers and nitrate in patients with significant coronary artery spasm (CAS) as assessed by acetylcholine provocation test up to 5 years.

Methods

A total 1727 patients with significant CAS were enrolled. They were divided into two groups: a trimetazidine group (trimetazidine, diltiazem, and nitrate, n = 695), and control group (diltiazem and nitrate, n = 473). After propensity score matching analysis, two matched groups (441 pairs, n = 882, C-statistic = 0.673) were generated. The individual and composite clinical end points [mortality, myocardial infarction (MI), revascularization, cerebrovascular accident (CVA), major adverse cardiac events (MACE), major adverse cardiac or cerebrovascular events (MACCE), and recurrent angina] were assessed up to 5 years for the two groups.

Results

At 5 years, there were similar incidences of individual and composite hard endpoints including mortality, MI, revascularization, CVA, MACE, MACCE, and recurrent angina in the two groups.

Conclusions

Additional long-term (5-year) treatment with trimetazidine in combination with diltiazem and nitrate in patients with significant CAS was not associated with improved clinical outcomes compared with combination therapy with diltiazem and nitrate only (without trimetazidine).

Notes

Compliance with Ethical Standards

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding

No external funding was used in the preparation of this manuscript.

Conflict of interest

Yong Hoon Kim, Ae-Young Her, Seung-Woon Rha, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo and Dong Joo Oh declare that they have no conflicts of interest that might be relevant to the contents of this manuscript.

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Yong Hoon Kim
    • 1
  • Ae-Young Her
    • 1
  • Seung-Woon Rha
    • 2
    • 3
  • Byoung Geol Choi
    • 2
  • Se Yeon Choi
    • 2
  • Jae Kyeong Byun
    • 2
  • Ahmed Mashaly
    • 3
  • Yoonjee Park
    • 2
    • 3
  • Won Young Jang
    • 3
  • Woohyeun Kim
    • 3
  • Jah Yeon Choi
    • 3
  • Eun Jin Park
    • 3
  • Jin Oh Na
    • 3
  • Cheol Ung Choi
    • 3
  • Hong Euy Lim
    • 3
  • Eung Ju Kim
    • 3
  • Chang Gyu Park
    • 3
  • Hong Seog Seo
    • 3
  • Dong Joo Oh
    • 3
  1. 1.Division of Cardiology, Department of Internal MedicineKangwon National University School of MedicineChuncheonSouth Korea
  2. 2.Department of MedicineKorea University Graduate SchoolSeoulSouth Korea
  3. 3.Cardiovascular CenterKorea University Guro HospitalSeoulSouth Korea

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