The combination of a 
HMG CoA reductase inhibitor like a 
statin, such as 
simvastatin, with a pFox inhibitor such as 
trimetazidine (“Simetazidine”) is particularly advantageous for treatment of end-stage complications, such as acute coronary syndrome (ACS) and chronic 
angina, especially in type II diabetics. The 
combination therapy is also useful in the treatment and / or prevention of chronic 
heart failure (CHF) and 
peripheral arterial disease (PAD). The combination of a 
nitric oxide (NO) mechanism with increased 
NO production with pFox inhibition simultaneously treats both the effect and the cause of 
angina. One or more 
oral hypoglycemic compounds (biguanides, 
insulin sensitizers, such as thiazolidinediones, α-
glucosidase inhibitors, 
insulin secretagogues, and 
dipeptidyl peptidase IV inhibitors), 
protein kinase C (PKC) inhibitors, and acetyl-CoA carboxylase inhibitors can also be used in combination with the 
HMG CoA reductase inhibitors and / or pFox inhibitors, especially in type II diabetics, to control glucose levels and treat 
endothelial dysfunction. The drugs can be given in combination (e.g. a single tablet) or in separate dosage forms, administered simultaneously or sequentially. In the preferred form the 
statin is given in a 
dose of between 5 and 80 mg / day in two separate doses, and the pFox inhibitor is administered in a sustained or extended dosage formulation at a 
dose of 20 mg three times a day or 35 mg two times a day. The 
dose of the 
oral hypoglycemic, PKC inhibitor, or acetyl-CoA carboxylase inhibitor varies with the type of 
drug used.