Early combination therapy with trimetazidine rapidly improves symptoms and quality of life in patients recently diagnosed with stable angina: The COMBINE angina study
Bibliographic record
Abstract
BACKGROUND: This real-world study evaluated the effectiveness and safety of an early combination of trimetazidine plus a calcium channel blocker (CCB) or β-blocker in patients with stable angina pectoris. METHODS: COMBINE Angina (NCT06298045) was a prospective observational study across five countries (Brazil, Egypt, India, Malaysia, Romania). Eligible patients were recently diagnosed with stable angina and remained symptomatic after 2-4 weeks of treatment with a first-line CCB or β-blocker. Patients initiated add-on trimetazidine and were followed over 4 months. The primary endpoint was the 7-item Seattle Angina Questionnaire (SAQ-7) summary score at 4 months. Secondary endpoints included SAQ-7 domain scores, Canadian Cardiovascular Society (CCS) angina severity class, frequency of angina attacks and short-acting nitrate use, patient- and physician-reported treatment satisfaction, and adverse events (AEs). RESULTS: The per-protocol population comprised 578 patients. Over 4 months, the mean ± standard deviation SAQ-7 summary score improved from 39.2 ± 13.7 to 78.4 ± 16.3 (out of 100; P < 0.0001). Significant improvements in all SAQ-7 domain scores, CCS class, and the frequency of angina attacks and short-acting nitrate use were also observed (all P < 0.0001 at each time point vs. baseline). Moreover, 85 % of patients remained on the same trimetazidine combination therapy, ≥90 % of patients and physicians were satisfied with treatment, and physicians for most patients (92 %) indicated that they would continue trimetazidine combination therapy beyond study end. A low incidence of treatment-related AEs (0.7 %) was reported. CONCLUSIONS: Early trimetazidine combination therapy can rapidly reduce the burden of angina in patients inadequately controlled by a first-line CCB or β-blocker. TAKE-HOME MESSAGE: The real-world COMBINE Angina study showed that early initiation of trimetazidine combination therapy can rapidly reduce the burden of stable angina in patients not promptly controlled by a first-line calcium channel blocker or β-blocker.
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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 | 0.003 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.003 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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".