Trimetazidine, a piperazine analogue, is a metabolic agent that selectively inhibits beta-oxidation. The effect of trimetazidine is to block fatty free acids and subsequently to enhance glucose oxidation. The results of both experimental and clinical researches provided evidences for antianginal effects and for improvement of coronary flow reserve with trimetazidine treatment. The current European Cardiac Society Guidelines on stable coronary artery disease suggest that trimetazidine be used as second-line treatment. Recent study indicate for beneficial effects of trimetazidine treatment in the population of patients after coronary revascularization (reduction of restenosis rate, improvement of left ventricle systolic function, reduction of angina episodes). However the results of currently ongoing large randomized trials are required to confirm this findings.