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13-09-2023 | Cardiomyopathy | Editorial

Trimetazidine to Reduce Myocardial Fibrosis—Competing Interests with SGLT2 Inhibitors?

Authors: Tyler B. Moran, Masafumi Kitakaze, Yochai Birnbaum

Published in: Cardiovascular Drugs and Therapy | Issue 5/2023

Excerpt

Trimetazidine is used to treat angina pectoris; however, its use is not approved in many countries including the USA. It has been reported that trimetazidine protects against ischemia–reperfusion injury. A recent study published in our Journal has shown that trimetazidine, started before primary percutaneous coronary intervention, reduced myocardial infarct size, as assessed by cardiac magnetic resonance imaging after 7 days in patients with ST elevation myocardial infarction [1]. Trimetazidine does not have significant hemodynamic effects but reportedly shifts cardiac cmetabolism from β-oxidation of free fatty acids towards glucose oxidation, which potentially affords more efficient utilization of oxygen in ischemic conditions [2, 3]. However, it should be mentioned that sodium-glucose cotransporter-2 inhibitors (SGLT2-I) that have consistently shown efficacy in patients with heart failure due to reduced, as well as preserved, systolic function are doing the opposite. SGLT2 inhibitors increase the utilization of fee fatty acid, ketones, and branched-chain amino acid and reduce the utilization of glucose [4]. …

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El-Khodary NM, Ghoneim AI, El-Tayaar AA, El-Touny EM. The impact of trimetazidine on cardiac fibrosis, inflammation, and function in ischemic cardiomyopathy patients. Cardiovasc Drugs Ther. 2022. https://doi.org/10.1007/s10557-022-07340-0.

Title: Trimetazidine to Reduce Myocardial Fibrosis—Competing Interests with SGLT2 Inhibitors?
Authors: Tyler B. Moran
Masafumi Kitakaze
Yochai Birnbaum
Publication date: 13-09-2023
Publisher: Springer US
Keyword: Cardiomyopathy
Published in: Cardiovascular Drugs and Therapy / Issue 5/2023
Print ISSN: 0920-3206
Electronic ISSN: 1573-7241
DOI: https://doi.org/10.1007/s10557-023-07508-2

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Trimetazidine to Reduce Myocardial Fibrosis—Competing Interests with SGLT2 Inhibitors?

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