144 cardiologists from 34 regions of Ukraine participated in prospective CLASSICA (The most Effective Combination of Antianginal Drugs in the Treatment of Patients with Stable Angina) study. The CLASSICA study consisted of two parts: the epidemiological section and the clinical section. The analysis of 1423 ambulatory records of patients with stable angina pectoris showed that the studied group of patients with stable angina included patients with high/very high risk, who often had long-term IHD with complications (ie, MI) and multiple concomitant pathologies, with poor control of angina symptoms, risk factors (weight, heart rate, and lipids), and insufficient frequency of coronary angiography and revascularization procedures.
The clinical part of the study was designed to be as close to real outpatient practice as possible. The aim of the clinical part of the CLASSICA study was to confirm the efficacy of combining original trimetazidine MR (TMZ MR) with traditional hemodynamic active agents for reduction of the number of angina attacks and nitrate consumption in 1213 patients with stable effort angina, functional class II–III (≥ 3 episodes of angina attacks per week) in the following treatment groups: beta-blocker (BB) + TMZ MR (1st group, n=400); BB + long-acting nitrate (LAN) + TMZ MR (2nd group, n=691); BB + calcium channel blocker CCB + TMZ MR (3rd group, n=122) after two months of therapy. Data analysis showed that after adding TMZ MR the number of angina attacks was substantially diminished on background treatment with BBs or their combination with LANs or CCBs. Maximal efficacy was among patients with more severe effort angina (≥ 7 heart attacks per week). The combined use of LANs or CCBs with BBs did not result in additional decrease in frequency of angina attacks per week compared with patients receiving only BBs and TMZ MR.