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What is the Olympic Russian skater's banned drug?

Reports that a Russian skater took a drug for angina left experts puzzled.

A drug you most likely can’t pronounce has emerged as a breakout star of these Olympic games in Beijing. That’s after 15-year-old Russian skater Kamila Valiyeva reportedly tested positive for a banned heart drug.

“I cannot imagine a figure skater taking this drug. It’s one big head scratcher. I can’t imagine a scenario where she would have taken it,” said Dr. Michael Joyner, a Mayo Clinic anesthesiologist and expert in human performance.

The team figure skating medal ceremony was delayed for an unspecified "legal reason," Russian media reported that Valiyeva had tested positive for trimetazidine in December before heading to the Games. The International Olympic Committee would not comment on reports of doping, calling it "complete speculation."

What is trimetazidine?

Trimetazidine is a fatty acid oxidation inhibitor used to prevent and treat the symptoms of angina, or chest pain that is the result of a lack of blood supply and oxygen to the heart. The drug, sometimes called TMZ, is banned by the World Anti-Doping Agency.

The drug could improve stamina in healthy young athletes, according to medical professionals.

"The drug can help by improving the efficiency of the heart in being able to deliver blood flow more effectively," Dr. Sadiya Khan, a cardiologist at Northwestern Medicine, told TODAY.

Who takes trimetazidine

Khan said it was extremely unlikely a 15-year-old would be prescribed the drug for heart troubles.

“It’s very rarely used in this country. It theoretically could help you if you had heart failure or coronary disease. It just doesn’t work that well,” Joyner said. “There are many other better options out there.” 

So if it doesn’t work, why is it banned?

“Why things get banned is — anything that has a remote possibility of influencing performance gets banned. You can get therapeutic use exemptions for medically legit drugs. Asthma drugs are the most common,” Joyner said. 

Why you might have heard of it

In 2014, Chinese swimming superstar Sun Yang tested positive for the banned substance, which the World Anti-Doping Agency (WADA) classified as a banned stimulant. But here’s where it gets tricky: The athlete’s doctor said he’d prescribed the drug starting in 2008 to treat the swimmer’s heart palpitations and dizziness.

In January 2015, WADA downgraded trimetazidine from “stimulant” to “modulator of cardiac metabolism” but it remains banned. 

The drug was also involved in a Russian bobsled case at the 2018 Olympics that ended in a settlement and the athletes accepting an eight-month ban.

Russian athletes are competing for the Russian Olympic Committee (ROC) in Beijing because Russia is banned from competing in international sporting events until December 2022 for running a state-sponsored doping program.

The bottom line

“If you talk to people, physicians and scientists, it’s never made a lot of sense why this is being used in the first place. Growth hormones and steroids make you stronger. Blood doping improves your endurance. Amphetamines stimulate you,” Joyner said. 

After all, the goal of performance enhancing drugs is to find ones that defy blood and urine tests. This one doesn’t. “It’s easy to test for — you want to find substances that are hard to test for. Sun Yang was busted for it. It’s a big head scratcher here. Was it someone thinking they could beat the doping system?” Joyner wondered. 

He’s even more confused as to why a champion skater would have this in her system. “Figure skaters would take the standard stuff to make them stronger, make them focus, and those are easy to test for. Or things that might improve your endurance. But she’s not running a marathon,” he says.