Effect of trimetazidine on the functional capacity of ischemic heart disease patients not suitable for revascularization: Meta-analysis of randomized controlled trials
Bibliographic record
Abstract
OBJECTIVE: To explore the effect of adding trimetazidine to other anti-anginal drugs on the functional capacity of ischemic heart disease (IHD) patients not suitable for revascularization when compared to first-line antianginal drugs alone. METHODS: MEDLINE and EMBASE databases were searched for English-language peer-reviewed randomized controlled trials (RCTs) comparing trimetazidine with first-line antianginal drugs alone or with placebo in IHD patients not suitable for revascularization and were included in this review. Quality of studies were assessed using the Cochrane collaboration "risk of bias" tool. RESULTS: Six RCTs, three were crossover studies. A total of 312 participants were included in this review. Overall quality of studies was moderate. Two studies found improvement in the 6-minute walking test (6-MWT) [standardized mean differences (SMD) 1.75; 95% CI 1.35 to 2.14; p <0.001], and two trials found improvement in the Canadian cardiovascular society (CCS) grading of angina class (SMD -1.37; 95% CI -1.89 to -0.84) in the trimetazidine group. Three of the better-quality trials found no increase in total exercise duration (TED) (SMD 0.34; 95% CI -0.10 to 0.78; p < 0.13). Significant heterogeneity was identified among trials describing outcomes for the New York Heart Association (NYHA) functional classification and left ventricular ejection fraction (LVEF %). CONCLUSION: Trimetazidine improve walking time and angina severity in IHD patients not suitable for revascularization. Due to the inconsistency of available evidence, RCTs targeting IHD patients with "no option" to undergo coronary revascularization is required to clarify this review question.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.021 | 0.044 |
| Meta-epidemiology (narrow) | 0.004 | 0.002 |
| Meta-epidemiology (broad) | 0.033 | 0.064 |
| Bibliometrics | 0.006 | 0.006 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.005 | 0.002 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".