Little-known drug at heart of Olympic doping drama has prompted past scandals

Russian figure skater Kamila Valieva's reported use of a heart medication that's banned by doping regulators puts her among a small group of top-flight athletes who’ve faced similar allegations in recent years.

Last week, Valieva became the first woman to land a quadruple jump in Olympic competition, which helped propel the Russian Olympic Committee team to a runaway gold medal. But then it was revealed that Valieva had tested positive for trimetazidine at the Russian Figure Skating Championships in St. Petersburg on Dec. 25, according to the International Testing Agency, which oversees the Olympic drug testing program.

Trimetazidine isn’t authorized in the U.S., but it is used in some countries to help prevent angina — chest pain resulting from a lack of blood supply and oxygen to the heart.

Although doctors question what, if any, competitive edge Valieva could have gained by taking the drug, she was nearly taken out of the Beijing Olympics as a result. The Court of Arbitration for Sport ruled Monday that she could maintain her place in the competition but that there won’t be a medal ceremony if she finishes in the top three because the case is unresolved.

Other athletes previously implicated in using trimetazidine include:

  • Chinese swimmer Sun Yang, a three-time Olympic gold medal winner who was prevented from competing in the Tokyo Games last year because of allegations he used the drug.
  • Russian bobsledder Nadezhda Sergeeva, who tested positive for trimetazidine at the 2018 Winter Olympics in PyeongChang, South Korea. Sergeeva was disqualified from the competition and served an eight-month ban. She finished 10th in the monobob in China on Monday.
  • The four members of Russia’s men’s quadruple sculls team, who were disqualified ahead of the 2016 Rio de Janeiro Olympics. Trimetazidine was found in a urine sample from rower Sergei Fedorovtsev in an out-of-competition test earlier that year.
  • Russian sprinter Kseniya Ryzhova, a world and European champion in the 4×400 relay, who got a nine-month ban in 2014 after she tested positive for trimetazidine. Ryzhova is best known, however, for causing a stir by kissing a teammate after a race in 2013.

Feb. 14, 202202:46

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Little is known of trimetazidine in the U.S. because it has never been reviewed for potential use and there are other medications, such as ranolazine, that treat symptoms of angina.

In theory, the drug could improve blood flow and allow athletes to performer better and longer, but many medical experts doubt it would yield much advantage.

Dr. Steven Nissen, a cardiologist at the Cleveland Clinic, said the news about Valieva's test surprised him.

"What popped into my mind is that I didn't think it seemed like a very good strategy to enhance performance," he said. "I would have never thought of it for use as a performance enhancement."

Dr. Benjamin Levine, a member of the American College of Cardiology's Sports and Exercise Cardiology Council, said a world-class teenage athlete like Valieva doesn’t fit the profile of a patient in need of trimetazidine.

"The chances of it helping a 15-year-old girl with a normal heart is virtually zero," said Levine, a professor of exercise science at the University of Texas' Southwestern Medical School.

"The chances of it being beneficial are extremely small. But it's unconscionable for somebody to have given this drug, whether knowing or unknowing, when you know it's banned," Levine added. "She's wonderful at this sport, and she's wonderful at it without trimetazidine."

The Russian Olympic Committee said Valieva has twice tested clear of the drug since December. The short program of women’s singles is scheduled to begin shortly after 5 a.m. ET Tuesday. Valieva is the heavy favorite to win.

David K. Li is a breaking news reporter for NBC News.

Rupa Palla and Whitney Lee contributed.

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