Original ArticlesMeeting the challenge of chronic ischaemic heart disease with trimetazidineMarzilli, Mario; Affinito, SilviaAuthor Information Postgraduate School of Cardiology, University of Siena, Siena, Italy Correspondence and requests for reprints to Professor Mario Marzilli, Policlinico Le Scotte, Cardiologia Universitaria, Viale Bracci, 53100 Siena, Italy Tel: +39 0577 585374; fax: +39 0577 233112; e-mail [email protected] Coronary Artery Disease: November 2005 - Volume 16 - Issue - p S23-S27 Buy Abstract The risk of cardiovascular events in patients with diabetes is similar to that of patients with previous history of ischaemic heart disease and the prevalence of ischaemic heart disease complicating diabetic syndromes is growing rapidly. Management of ischaemic heart disease in diabetic patients remains a challenge. Therapeutic options include several antianginal agents, and mechanical removal of coronary obstructions by percutaneous transluminal coronary angioplasty, and aorto-coronary by-pass surgery. Unfortunately, all treatments are less effective in diabetic patients than in nondiabetic patients. Direct modulation of cardiac metabolic alterations associated with the diabetic syndrome appears as a promising alternative for the management of ischaemic heart disease in diabetic patients. Results obtained in anginal patients with the metabolic agent trimetazidine are consistent with this hypothesis. © 2005 Lippincott Williams & Wilkins, Inc.