We studied the influence of trimetazidine MR on exercise tolerance and carbohydrate metabolism in 28 patients with stable effort angina, treated with metoprolol. The addition of trimetazidine MR to ongoing therapy with metoprolol substantially enhanced the antianginal and anti-ischemic efficacy of treatment. The most significant improvement was observed when the monotherapy with metoprolol wasn’t effective. In this subgroup of patients the threshold exercise duration increased by 77,1±18,1 s (p
Aim. To study the effects of a β-adrenoblocker (β-AB) metoprolol (Mp) and its combination with trimetazidine (Tmd) on glucose tolerance and insulin sensitivity in patients with angina pectoris. Material and methods. In total, 28 men aged 46-68 years, with Functional Class (FC) II-III stable angina, positive exercise stress test (EST), and no prior β-AB therapy were examined. Individual Mp doses were selected based on the paired EST results. For one month, the Mp dose of 50 or 100 mg/d was administered twice a day; for the next month, participants received Mp and Tmd (70 mg/d). A standard glucose tolerance test (GTT) was performed at baseline and at the end of one-month periods of Mp or Mp + Tmd treatment. Carbohydrate metabolism disturbances were diagnosed according to the WHO criteria (1999). Insulin resistance (IR) was assessed by HOMA2-IR parameter, and tissue insulin sensitivity by ISI0,120 parameter. Results. After one month of Mp treatment, a decrease in fasting glucose levels was observed (p=0,025). At the same time, the GTT results demonstrated increased glucose levels 2 hours after glucose load, compared to baseline (p=0,049). Tissue insulin sensitivity (ISI0,120) showed some reduction (p=0,14), while the number of patients with impaired glucose tolerance (IGT) increased from 4 to 8 (p=0,006). The levels of fasting and post-load glycemia after one month of the combination therapy with Mp and Tmd were similar to those after the Mp treatment. Insulin levels at 2 hours after glucose load were higher than those observed after the Mp therapy (p=0,045). Compared to baseline, HOMA2-IR values increased, and IDI0,120 values decreased (p=0,036). The IDI0,120 dynamics suggested a reduction in insulin sensitivity for both treatment regimens. IGT was registered in 10 patients. Conclusion. In angina patients, impaired glucose control was observed as early as 1 month after the start of Mp treatment. This early impairment could be diagnosed by GTT. Although the combination therapy with Mp and Tmd did not prevent this impairment, but provided a greater antiischemic effect and, therefore, was clinically appropriate
Aim. To study the association between antiischemic effects (AIE) of metoprolol (MP), glucose tolerance, and insulin sensitivity in patients with stable angina (SA). Material and methods. The study included 28 male patients, aged 46-68 years, with stable effort angina, Functional Class II-III, and positive exercise stress test (EST). The time of the ST segment depression by ≥1 mm defined the threshold exercise stress time. MP in a selected dose was administered twice a day, for one month. Its hemodynamic effects were assessed by the dynamics of heart rate (HR), blood pressure (BP), and double product (DP). Glucose tolerance test (GTT) was performed at baseline (before MP administration) and after one month of MP treatment. Tissue insulin sensitivity and insulin resistance (IR) were assessed by ISI0.120 and HOMA-IR parameters, respectively. Results. AIE was registered in 57% of the patients, while 43% failed to demonstrate it. Both groups did not differ by the extent of MP impact on the levels of HR, BP, and DP. The presence or absence of AIE was linked to selected parameters of glucose metabolism. In patients with AIE, the pre-treatment levels of glucose and insulin 2 hours after glucose load were higher (p=0,028 and 0,043, respectively) and ISI1,120 values lower than in patients without AIE (p=0,023). Among participants with AIE, impaired glucose tolerance (IGT) was observed in 4 at baseline and in 8 one month later; among patients without AIE, IGT was not registered. Conclusion. For the first time, the presence of AIE during MP therapy of SA patients was linked to the decreased insulin sensitivity of peripheral tissues (ISI0.120). Paired EST with a single MP dose at baseline provides an opportunity to identify the patients with a higher risk of metabolic disturbances during the longer-term MP treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.