Key findings from the ATPCI trial were described as a Hot Line at ESC Congress 2020 today by Principal Investigator, Professor Roberto Ferrari (University of Ferrara, Italy). This double-blind trial enrolled 6,007 patients who had undergone successful PCI, either elective for stable angina (n=3,490) or urgent for unstable angina or non-ST-elevation myocardial infarction (n=2,517). Patients were randomly assigned to receive either trimetazidine (modified release 35 mg twice daily) or placebo, both in addition to standard therapy.
The primary efficacy endpoint was the composite of cardiac death, hospitalisation for a cardiac event, or recurrent/persistent angina leading to adding, switching or increasing the dose of antianginal drugs or coronary angiography. After a median follow-up of 5 years, there was no difference between the groups in the rate of the primary efficacy endpoint: 700 (23.3%) patients in the trimetazidine group and 714 (23.7%) patients in the placebo group (p=0.7). There was also no difference between the groups in the rate of adverse events.
Prof. Ferrari concluded, “The trial shows that trimetazidine does not improve outcomes or symptoms after successful PCI in patients with acute and chronic coronary syndromes.”