Trimetazidine in the management of ischemic heart disease in a patient with diabetes mellitus and recurrent angina

Acute coronary syndromes in diabetic patients often pose therapeutic challenges. Both percutaneous and surgical revascularization procedures have a lower success rate and a greater complication rate in diabetics compared to non diabetic patients. Here we discuss the case of an old diabetic patient with angina recurring 15 year after a CABG operation. Based on coronary anatomy and clinical presentation, several options were considered, including re-do operation, percutaneous revascularization, and medical therapy alone. A combination of PCI and trimetazidine addition to standard medical therapy was eventually chosen. This approach has been very effective and has so far protected the patient from angina. Heart Metab. 2008;38:31–33.