About Trimetazidine Cytoprotective,vasodilator, Anti-ischemic (anti-anginal) agent. Mechanism of Action of Trimetazidine It is a cytoprotective drug which reduces anginal attacks and improves exercise tolerance by nonhaemodynamic mechanisms. It improves cellular tolerance to ischaemia by: - 1) Inhibiting mitochondrial long chain 3-ketoacyl-CoA-thiolase- a key enzyme in fatty acid oxidation and there by reducing fatty acid metabolism and increasing glucose metabolism in myocardium. 2) Limiting intracellular acidosis and sodium and calcium accumulation during ischaemia. 3) Protecting against O* free radical induced membrane damage