According to a commentary, symptomatic left ventricular outflow tract obstruction has been the focus of treatment interventions for patients with hypertrophic cardiomyopathy (HCM) for decades, with negative inotropic drugs and septal reduction therapy for medically refractory cases proving to be highly effective strategies for alleviating outflow tract obstruction and improving symptoms. However, symptomatic, nonobstructive HCM has proven a bigger challenge, and to date, therapeutic options are limited to a trial-and-error approach with a combination of β-blockers, calcium channel blockers, and diuretics. It highlights that developing effective and targeted therapies for symptomatic non-obstructive HCM is therefore imperative and represents one of the largest unmet needs in the field.
Trimetazidine is not licensed in the UK but is in other countries as add-on therapy for the symptomatic treatment of patients with stable angina pectoris who are inadequately controlled by or intolerant to first-line antianginal therapies.