Iranian Heart Association Iranian Heart Journal 27 2 2026 04 01 The Effect of Trimetazidine Treatment in Diabetic Patients With Intermittent Claudication 6 16 242135 EN Osama Ahmed Amin Department of Cardiology, Beni-Suef University, Egypt. 0000-0001-5461-9720 Marina Awad Department of Cardiology, Beni-Suef University, Egypt. Ahmed Mohamed Hamam Department of Endocrinology and Metabolism, Armed Forces College of Medicine, Egypt. Ahmed Farouk Alaarag Department of Cardiology, Tanta University, Egypt. 0000-0002-9364-6286 Journal Article 2025 02 03 Background: Peripheral arterial disease (PAD) is a vascular condition for which many therapeutic decisions are well established; nonetheless, the potential role of trimetazidine (TMZ) in diabetic patients with PAD remains debatable and warrants further investigation. Objective: This study aimed to determine the effect of TMZ on diabetic patients with intermittent claudication. Methods: In this two-center prospective study, 188 diabetic patients with PAD received guideline-directed medical therapy (GDMT) with (n =93) or without (n =95) TMZ. Baseline and 6-month assessments included the 6-minute walk test (6MWT), ankle-brachial index (ABI), duplex ultrasound, and diabetic foot outcomes (P <0.05). Results: The study included 188 diabetic patients with symptomatic PAD. Patients were divided into Group I, which received all GDMT with TMZ as part of chronic coronary syndrome treatment (93 patients), and Group II, which received all GDMT without TMZ (95 patients). All patients were evaluated at baseline and after a 6-month follow-up period for exercise performance via 6MWT, lower limb hemodynamics via ABI, and the incidence of diabetic foot requiring amputation. At the end of the follow-up period, 6MWT and ABI improved significantly from baseline findings in both groups. The TMZ group demonstrated a substantial improvement in 6MWT, a nonsignificant improvement in ABI, and a nonsignificant reduction in diabetic foot requiring amputation compared with the non-TMZ group. Conclusions: TMZ may improve exercise performance in diabetic patients with PAD, while its role in improving limb hemodynamics or ischemia is nonsignificant and uncertain. (Iranian Heart Journal 2026; 27(2): 6-16)

https://journal.iha.org.ir/article_242135_9b75b5a32dae4f35c74279ed45cd9b43.pdf