Trimetazidine Antianginal drug that act by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase enzyme. Reduced fatty acid metabolism and increased glucose metabolism in myocardium leading to a paial shift from FFA to glucose oxidation in the hea, which provides less ATP but requires less O2 and may therefore be beneficial in ischemia. Efficient in reducing angina and increase exercise tolerance, paicularly in patients with diabetes and hea failure.