Invited review
The role of trimetazidine in patients subjected to surgical revascularization

In recent years methods interfering with cellular metabolism to prevent and treat heart diseases have become available. Metabolic treatment involves the use of drugs to improve the function of cardiomyocytes. Trimetazidine (TMZ) is one of the drugs in this group. The ESC 2006 guidelines on the management of patients with stable angina indicated the efficacy of metabolic treatment in improving the physical efficiency and decreasing the recurrence of pain. The available data suggest that a combined therapy of TMZ and haemodynamic drugs is an effective antianginal treatment that significantly reduces the risk of pain recurrence. The most recent studies also suggest that TMZ might be highly effective in patients subjected to surgical revascularization. However, as there have only been a few studies so far, and most of them included a very small number of patients, this treatment cannot be recommended until large, randomized trials are performed. On the other hand, TMZ can be considered as an alternative, additional treatment in patients subjected to cardiac surgery.