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According to Dr Austin, there is a gap between clinical trials and real life

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observed significantly lower O pulse and higher VE/VO with Meldonium compared with placebo, patterns consistent with reduced aerobic exercise capacity, and no between-group differences in blood lactate 5 min after maximal exercise ( Anaerobic capacity In obese rats, Meldonium lowered blood lactate concentrations during high-intensity exercise ( Recovery and cardioprotection Meldonium may shorten recovery after cardiac events and improve indices of cardiac function in patients with coronary disease or diabetes, as well as in animals exposed to high altitude or other stressors (6669)

One is that it's been demonstrated to help slow the aging procedure