<HTML><BODY style="word-wrap: break-word; -khtml-nbsp-mode: space; -khtml-line-break: after-white-space; "><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dear Dr Salim Ben Khedda from Cardiology division Mustapha Hospital medical Center Algeirs Algeria: Here Andrés Ricardo Pérez Riera from Sao Paulo Brazil.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">They are several randomized papers mainly from Italy (Clinical Cardiology-Heart Failure Unit, Istituto Scientifico-Universita Vita/Salute San Raffaele,Milan ) but not related directly to mortality.</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Please see bellow</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">Main indexed Trimetazidine references with randomized double-blind methodology</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><B><FONT class="Apple-style-span" face="Arial"> </FONT></B></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><B><FONT class="Apple-style-span" face="Arial">Fragasso G, Palloshi A, Puccetti P, et al. A randomized clinical trial of trimetazidine, a partial free fatty acid oxidation inhibitor, in patients with heart failure. J Am Coll Cardiol. 2006;48(5):992-8.</FONT></B></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">Clinical Cardiology-Heart Failure Unit, Istituto Scientifico-Universita Vita/Salute San Raffaele, Milan, Italy. </FONT><A href="mailto:gabriele.fragasso@hsr.it"><FONT class="Apple-style-span" color="#002FD7"><FONT class="Apple-style-span" face="Arial">gabriele.fragasso@hsr.it</FONT></FONT></A></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">OBJECTIVES: This study sought to assess whether the long-term addition of trimetazidine to conventional treatment could improve functional class, exercise tolerance, and left ventricular function in patients with heart failure (HF). BACKGROUND: Previous small studies have shown that trimetazidine may be beneficial in terms of left ventricular function preservation and control of symptoms in patients with post-ischemic HF. METHODS: Fifty-five patients with HF were </FONT><FONT class="Apple-style-span" color="#F13934"><B><FONT class="Apple-style-span" face="Arial">randomly allocated in an open-label fashion</FONT></B></FONT><FONT class="Apple-style-span" face="Arial"> to either conventional therapy plus trimetazidine (20 mg three times daily) (28 patients) or conventional therapy alone (27 patients). Mean follow-up was 13 +/- 3 months. At study entry and at follow-up, all patients underwent exercise testing and two-dimensional echocardiography. Among the others, New York Heart Association (NYHA) functional class and ejection fraction (EF) were evaluated. RESULTS: In the trimetazidine group, NYHA functional class significantly improved compared with the conventional therapy group (p < 0.0001). Treatment with trimetazidine significantly decreased left ventricular end-systolic volume (from 98 +/- 36 ml to 81 +/- 27 ml, p = 0.04) and increased EF from 36 +/- 7% to 43 +/- 10% (p = 0.002). On the contrary, in the conventional therapy group, both left ventricular end-diastolic and -systolic volumes increased from 142 +/- 43 ml to 156 +/- 63 ml, p = 0.2, and from 86 +/- 34 ml to 104 +/- 52 ml, p = 0.1, respectively; accordingly, EF significantly decreased from 38 +/- 7% to 34 +/- 7% (p = 0.02). CONCLUSIONS: In conclusion, long-term trimetazidine improves functional class and left ventricular function in patients with HF. This benefit contrasts with the natural history of the disease, as shown by the decrease of EF in patients on standard HF therapy alone.</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">PMID: 16949492 [PubMed - indexed for MEDLINE]</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><B><FONT class="Apple-style-span" face="Arial">Fragasso G, Montano C, Perseghin G, Palloshi A, et al. The anti-ischemic effect of trimetazidine in patients with postprandial myocardial ischemia is unrelated to meal composition. Am Heart J. 2006;151:1238.e1-8.</FONT></B></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">Heart Failure Unit, Clinical Cardiology, Istituto Scientifico/Universita' San Raffaele, Milan, Italy. </FONT><A href="mailto:gabriele.fragasso@hsr.it"><FONT class="Apple-style-span" color="#002FD7"><FONT class="Apple-style-span" face="Arial">gabriele.fragasso@hsr.it</FONT></FONT></A></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">BACKGROUND: Previous studies provide evidence for a significant reduction of coronary flow reserve after ingestion of meals of different compositions. A possible role of hyperinsulinemia and increased free fatty acid levels, which are deleterious during acute myocardial ischemia and reperfusion, has been hypothesized. We assessed in patients with stable coronary disease the effects of high-fat meals (HFMs) and high-carbohydrate meals (HCMs) on ischemic threshold and stress left ventricular function on placebo and after partial fatty acid inhibition by trimetazidine (TMZ). METHODS: Ten patients (9 men, age 68 +/- 7 years) were allocated to placebo and TMZ (40 mg TID), both administered in the 24 hours preceding testing, according to</FONT><FONT class="Apple-style-span" color="#F13934"><B><FONT class="Apple-style-span" face="Arial"> a randomized double-blind study design.</FONT></B></FONT><FONT class="Apple-style-span" face="Arial"> All patients underwent stress (treadmill exercise testing according to the Bruce protocol) echocardiography after fasting (8 hours) and after an HFM and HCM (2 hours) either on placebo or on TMZ. Time to 1-mm ST-segment depression (time to 1 mm) and stress wall motion score index (WMSI) were evaluated. RESULTS: An HFM did not affect exercise variables compared with fasting, whereas an HCM resulted in a reduction of the ischemic threshold (time to 1 mm from 402 +/- 141 to 292 +/- 123 seconds, P = .025). Compared with placebo, TMZ improved time to 1 mm after fasting, HFM, and HCM (432 +/- 153 vs 402 +/- 141, 439 +/- 118 vs 380 +/- 107, 377 +/- 123 vs 292 +/- 123, F(1,9) = 26.91, P = .0006). Compared with placebo, on TMZ, stress WMSI decreased from 1.55 +/- 0.25 to 1.29 +/- 0.14 after fasting, from 1.57 +/- 0.10 to 1.39 +/- 0.28 after HFM, and from 1.64 +/- 0.21 to 1.39 +/- 0.21 after HCM (F(1,9) = 37.04, P = .0002). Interestingly, stress WMSI on TMZ was never different from rest WMSI on placebo. CONCLUSIONS: In patients with coronary disease, exercise testing after an HCM results in more severe myocardial ischemia compared with that after an HFM. The observed beneficial effects of the partial fatty acid inhibitor TMZ seem to be unrelated to meal composition and are possibly caused by the better glucose use induced by the drug.</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">PMID: 16781225 [PubMed - indexed for MEDLINE]</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><B><FONT class="Apple-style-span" face="Arial">Fragasso G, Perseghin G, De Cobelli F, et al.Effects of metabolic modulation by trimetazidine on left ventricular function and phosphocreatine/adenosine triphosphate ratio in patients with heart failure. Eur Heart J. 2006;27:942-948.</FONT></B></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">Department of Clinical Cardiology, Heart Failure Clinic, Istituto Scientifico/Universita' San Raffaele, Via Olgettina 60, 20132 Milano, Italy. </FONT><A href="mailto:gabriele.fragasso@hsr.it"><FONT class="Apple-style-span" color="#002FD7"><FONT class="Apple-style-span" face="Arial">gabriele.fragasso@hsr.it</FONT></FONT></A></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">AIMS: The addition of trimetazidine to standard treatment has been shown to improve left ventricular (LV) function in patients with heart failure. The aim of this study is to non-invasively assess, by means of in vivo 31P-magnetic resonance spectroscopy (31P-MRS), the effects of trimetazidine on LV cardiac phosphocreatine and adenosine triphosphate (PCr/ATP) ratio in patients with heart failure. METHODS AND RESULTS: Twelve heart failure patients were randomized in a double-blind, cross-over study to placebo or trimetazidine (20 mg t.i.d.) for two periods of 90 days. At the end of each period, all patients underwent exercise testing, 2D echocardiography, and MRS. New York Heart Association (NYHA) class, ejection fraction (EF), maximal rate-pressure product, and metabolic equivalent system (METS) were evaluated. Relative concentrations of PCr and ATP were determined by cardiac 31P-MRS. On trimetazidine, NYHA class decreased from 3.04+/-0.26 to 2.45+/-0.52 (P = 0.005), whereas EF (34+/-10 vs. 39+/-10%, P = 0.03) and METS (from 7.44+/-1.84 to 8.78+/-2.72, P = 0.03) increased. The mean cardiac PCr/ATP ratio was 1.35+/-0.33 with placebo, but was increased by 33% to 1.80+/-0.50 (P = 0.03) with trimetazidine. CONCLUSION: Trimetazidine improves functional class and LV function in patients with heart failure. These effects are associated to the observed trimetazidine-induced increase in the PCr/ATP ratio, indicating preservation of the myocardial high-energy phosphate levels.</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">PMID: 16510466 [PubMed - indexed for MEDLINE</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><B><FONT class="Apple-style-span" face="Arial">Iskesen I, Saribulbul O, Cerrahoglu M,et al. Trimetazidine reduces oxidative stress in cardiac surgery. Circ J. 2006 Sep;70(9):1169-73. Department of Cardiovascular Surgery, Celal Bayar University School of Medicine, Turkey. </FONT></B><A href="mailto:iskesen@yahoo.com"><FONT class="Apple-style-span" color="#002FD7"><B><FONT class="Apple-style-span" face="Arial">iskesen@yahoo.com</FONT></B></FONT></A></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><B><FONT class="Apple-style-span" face="Arial">BACKGROUND: </FONT></B><FONT class="Apple-style-span" face="Arial">Trimetazidine is an anti-ischemic agent that is used to treat angina and it has cardioprotective effects without inducing any significant hemodynamic changes. It inhibits the long-chain mitochondrial 3-ketoacyl coenzyme A thiolase enzyme in the myocyte and can improve cardiac mitochondrial metabolism, as well as scavenge free radicals. The aim of </FONT><FONT class="Apple-style-span" color="#F13934"><B><FONT class="Apple-style-span" face="Arial">this double-blind prospective randomized study </FONT></B></FONT><FONT class="Apple-style-span" face="Arial">was to investigate the effect of preoperative use of trimetazidine on the reduction of oxidative stress during coronary artery bypass grafting (CABG) under cardiopulmonary bypass (CPB). METHODS AND RESULTS: The study group (group T) and the control group (group C) each comprised 12 patients. Pretreatment began 2 weeks before CABG with trimetazidine (60 mg/day po); the control group did not receive any medication. Serial blood samples were collected before and after CPB for measurement of the serum concentrations of these major endogenous antioxidant enzyme systems, which are markers for oxidative degradation of the cellular membranes; postoperative levels were significantly different between the groups (p<0.05). There were no significant difference in hemodynamic values. CONCLUSION: The findings suggest that pretreatment with trimetazidine alleviates malondialdehyde production and preserves endogenous antioxidant capacity during CABG with CPB and cardioplegic arrest.</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">PMID: 16936431 [PubMed - indexed for MEDLINE]</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><B><FONT class="Apple-style-span" face="Arial">Chaloupka V. Trimetazidine in the treatment of stable angina pectoris TRIADA-(trimetazidine in stable angina twice daily) Vnitr Lek. 2006 Jun;52(6):609-14. [Article in Czech]</FONT></B></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">Interni kardiologicka klinika Lekarske fakulty MU a FN Brno. </FONT><A href="mailto:vchaloup@fnbrno.cz"><FONT class="Apple-style-span" color="#002FD7"><FONT class="Apple-style-span" face="Arial">vchaloup@fnbrno.cz</FONT></FONT></A></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"> Links</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">Comment in:</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">Vnitr Lek. 2006 Jun;52(6):556-7.</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">Vnitr Lek. 2006 Jun;52(6):558-9.</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">The primary objective of the national study TRIADA was to evaluate the efficacy and tolerability of Preductal MR (trimetazidine) at a dose of 35 mg twice daily which was added to current therapy involving the maximum of two antianginal drugs. The outcome was evaluated after 12 weeks of therapy and compared with baseline data. The study included 74 patients with stable exertional angina pectoris (AP) and positive exercise testing results. Trimetazidine (Preductal MR) at a dose of 35 mg twice daily was added to their current therapy involving two drugs at most. TRIADA confirmed that the use of trimetazidine in a new pharmacological form is effective and well tolerated in the treatment of angina pectoris. The study also confirmed a beneficial effect of trimetazidine on the incidence of angina pectoris paroxysms and objective manifestations of ischaemia during exercise testing. Holter monitoring clearly showed that metabolic therapy added to standard antianginal therapy would reduce the incidence of symptomatic and asymptomatic ischaemia. In addition, 12-week therapy with trimetazidine helped improve all end points of quality of life of AP patients evaluated using a questionnaire for AP patients (The Seattle Angina Questionnaire).</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">PMID: 16871765 [PubMed - indexed for MEDLINE]</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><B><FONT class="Apple-style-span" face="Arial">Topal E, Ozdemir R, Barutcu I, et al. The effects of trimetazidine on heart rate variability in patients with slow coronary artery flow. J Electrocardiol. 2006 Apr;39(2):211-8.</FONT></B></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">Cardiology Department, Faculty of Medicine, Inonu University, Malatya 34300, Turkey.</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial">OBJECTIVE: We sought to examine the effect of trimetazidine (TMZ) on heart rate variability (HRV), endothelin-1 (ET-1), NO, and anginal symptoms in patients with slow coronary artery flow (SCAF). METHODS: The 48 patients with SCAF (29 women and 19 men; mean age, 52 +/- 9 years) were included in the study. Twenty milligrams TMZ 3 times a day or matched placebo were given </FONT><FONT class="Apple-style-span" color="#F13934"><B><FONT class="Apple-style-span" face="Arial">randomly in a double-blinded fashion for 4 weeks.</FONT></B></FONT><FONT class="Apple-style-span" face="Arial"> Patients were divided into 4 groups as follows: exercise-positive, TMZ-given group (group A, n = 12); exercise-positive, placebo-given group (group B, n = 12); exercise-negative, TMZ-given group (group C, n = 12); and exercise-negative, placebo-given group (group D, n = 12). RESULTS: After TMZ treatment, HRV parameters, including SD of the all R-R intervals, SD of the averages of R-R intervals in all 5-minute segments of the entire recording, percentage of R-R intervals with more than 50-millisecond variation, and the square root of the mean of the sum of the squares of differences between adjacent R-R intervals, significantly improved both in exercise-positive and exercise-negative groups when compared with baseline. After TMZ treatment, ET-1 and NO levels significantly altered both in exercise-positive and exercise-negative groups when compared with baseline (17.7 +/- 2.7 vs 13.9 +/- 2.8 pg/mL [P = .01] and 18.1 +/- 3.8 vs 14.2 +/- 2.6 pg/mL [P = .01], respectively). After TMZ treatment, NO levels significantly increased in both exercise-positive and exercise-negative groups when compared with baseline (36.4 +/- 5.4 vs 43.3 +/- 6.8 micromol/L [P = .01] and 36.8 +/- 7.8 vs 43.3 +/- 4.8 micromol/L [P = .01], respectively). However, in placebo group, neither HRV parameters nor ET-1 and NO levels altered when compared with baseline. Also, after treatment, a significant correlation was detected between HRV parameters, including SD of the averages of R-R intervals in all 5-minute segments of the entire recording, SD of the all R-R intervals, percentage of R-R intervals with more than 50-millisecond variation, and the square root of the mean of the sum of the squares of differences between adjacent R-R intervals, and NO and ET-1 levels in TMZ group but not placebo. CONCLUSION: Short-term TMZ therapy improved HRV parameters and endothelial products such as ET-1 and NO as well as anginal symptom in patients with SCAF. Improvement in HRV parameters was correlated with ET-1 and NO levels.</FONT></DIV><DIV style="text-align: auto;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial"> PMID: 16580422 [PubMed - indexed for MEDLINE]</FONT></DIV><P style="margin: 0.0px 0.0px 0.0px 48.0px"><FONT class="Apple-style-span" face="Arial"> </FONT></P><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 48px; "><FONT class="Apple-style-span" face="Arial"> All the best</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 24px; "><FONT class="Apple-style-span" face="Arial">Andrés Ricardo Pérez Riera</FONT></DIV><DIV style="text-align: justify;margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 24px; "><FONT class="Apple-style-span" face="Arial">Chief of Electro-Vectocardiology Sector of the Discipline of Cardiology,ABC Faculty of Medicine (FMABC), Foundation of ABC (FUABC)- Santo André -São Paulo - Brazil. Rua Sebastião Afonso 885 - Zip Code: 044417-100- Jardim Miriam S.P.- Brazil </FONT></DIV><FONT class="Apple-style-span" face="Arial"><BR></FONT><DIV> <SPAN class="Apple-style-span" style="border-collapse: separate; -khtml-border-horizontal-spacing: 0px; -khtml-border-vertical-spacing: 0px; color: rgb(0, 0, 0); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; -khtml-text-decorations-in-effect: none; text-indent: 0px; -apple-text-size-adjust: auto; text-transform: none; orphans: 2; white-space: normal; widows: 2; word-spacing: 0px; "><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">--</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dr.</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Sergio</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Dubner</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">President</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">of</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Scientific</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Committee</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; "><FONT class="Apple-style-span" face="Arial" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR style=""></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dr.</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Edgardo</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Schapachnik</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">President</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">of</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Steering</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Committee</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV></SPAN></DIV><DIV><BLOCKQUOTE type="cite"><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; min-height: 14px; "><FONT class="Apple-style-span" face="Arial"><BR></FONT></DIV> <DIV><FONT class="Apple-style-span" face="Arial">Dear colleagues,</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">Congratulation for this exellent meeting;</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">I want to ask a question to Dr Andrés Ricardo Pérez Riera. in term of </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">evidence based medecine is there any trial showing an improvoment of morbi </FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">mortality by using Trimetazidine (TMZ) Vartel</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">Thank you very much for your consideration to this message.</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">salim BEN KHEDDA</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">cardiology division</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">Mustapha Hospital medical Center</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial">Algeirs Algeria</FONT></DIV><FONT class="Apple-style-span" face="Arial"><BR></FONT><DIV> <SPAN class="Apple-style-span" style="border-collapse: separate; -khtml-border-horizontal-spacing: 0px; -khtml-border-vertical-spacing: 0px; color: rgb(0, 0, 0); font-style: normal; font-variant: normal; font-weight: normal; letter-spacing: normal; line-height: normal; -khtml-text-decorations-in-effect: none; text-indent: 0px; -apple-text-size-adjust: auto; text-transform: none; orphans: 2; white-space: normal; widows: 2; word-spacing: 0px; "><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">--</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dr.</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Sergio</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Dubner</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">President</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">of</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Scientific</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Committee</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; font: normal normal normal 13px/normal Lucida Grande; min-height: 16px; "><FONT class="Apple-style-span" face="Arial" size="3"><SPAN class="Apple-style-span" style="font-size: 12px;"><BR style=""></SPAN></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Dr.</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Edgardo</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Schapachnik</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">President</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">of</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Steering</FONT><SPAN class="Apple-converted-space"><FONT class="Apple-style-span" face="Arial"> </FONT></SPAN><FONT class="Apple-style-span" face="Arial">Committee</FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><DIV><FONT class="Apple-style-span" face="Arial"><BR class="khtml-block-placeholder"></FONT></DIV><FONT class="Apple-style-span" face="Arial"><BR class="Apple-interchange-newline"></FONT></SPAN><FONT class="Apple-style-span" face="Arial"> </FONT></DIV><FONT class="Apple-style-span" face="Arial"><BR></FONT><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">_______________________________________________</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial">Scd-forum mailing list</FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><A href="mailto:Scd-forum@scd-symposium.org">Scd-forum@scd-symposium.org</A></FONT></DIV><DIV style="margin-top: 0px; margin-right: 0px; margin-bottom: 0px; margin-left: 0px; "><FONT class="Apple-style-span" face="Arial"><A href="http://www.grupoakros.com.ar/mailman/listinfo/scd-forum">http://www.grupoakros.com.ar/mailman/listinfo/scd-forum</A></FONT></DIV> </BLOCKQUOTE></DIV><FONT class="Apple-style-span" face="Arial"><BR></FONT></BODY></HTML>