Interní Med. 2013; 15(6-7): 215-219

Metabolic treatment of stable angina pectoris

MUDr.Andrea Chudícová, doc.MUDr.Petr Ošťádal, Ph.D.

Kardiologické oddělení, Kardiovaskulární centrum, Nemocnice Na Homolce, Praha

The treatment of stable angina pectoris (AP) based on affecting cardiomyocyte metabolism has been under investigation for a number of

years. New approaches in improving and optimizing cardiac energy metabolism by pharmacologically intervening in a complex cascade

of events during ischemia at various levels are promising methods to protect cardiomyocytes. The basic principle involves inhibition of

fatty acid oxidation and stimulation of glucose metabolism. Also available, however, are other strategies, such as affecting ATP storage

by directly interfering with nucleotide metabolism. In the Czech Republic, trimetazidine is the most widespread and well-established

drug; its effects on increasing exercise tolerance and reducing the rate of angina attacks in patients with stable AP have repeatedly been

proved in practice. In some countries, ranolazine and, in certain limited indications, perhexiline are also available. The use of some other

substances, including commercially available agents (allopurinol, D-ribose, L-carnitine), is in the phase of clinical research.

Keywords: angina pectoris, trimetazidine, ranolazine, allopurinol

Published: July 15, 2013  Show citation