Treatment of transient myocardial ischemia in patients with stable angina: a comparative study of verapamil slow-release and nifedipine plus propranolol.
We compared the effect of verapamil slow-release (VSR) and the combination of nifedipine plus propranolol on transient myocardial ischemia in a double-blind study comprising 20 patients with proven coronary artery disease and chronic stable angina. According to the results of 24-h Holter-monitoring recording, patients were divided into two groups: 10 patients with fixed coronary reserve and 10 patients with variable coronary reserve. The number of ischemic events was reduced with both therapies: from 12 +/- 10 at baseline to 3.4 +/- 4.0 (p less than 0.05) with verapamil and to 3.9 +/- 7.0 (p less than 0.05) with nifedipine plus propranolol (N + P). When total ischemic burden was measured, findings were similar: It was reduced from 104 +/- 196 min to 27 +/- 57 (p less than 0.05) with N + P and to 17 +/- 18 min with verapamil in patients with fixed coronary reserve and from 36 +/- 44 to 5 +/- 9 min (p less than 0.05) with verapamil and to 5 +/- 10 min with N + P in patients with a variable coronary reserve. VSR shows antiischemic efficacy similar to that of the combination of N + P in treatment of transient myocardial ischemia in patients with stable angina.
Molinero
E
E
Servicio de Cardiología, Hospital Civil de Basurto, Bilbao, Spain.
Salcedo
A
A
Sagastagoitia
J D
JD
Arzubiaga
J
J
Iriarte
M M
MM
Gómez Pajuelo
C
C
Fernández Vidal
P
P
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000188:drug therapy*; D003327:Coronary Disease / Q000150:complications / Q000188:drug therapy*; D003692:Delayed-Action Preparations; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage / Q000627:therapeutic use*; D011433:Propranolol / Q000008:administration & dosage / Q000627:therapeutic use*; D011897:Random Allocation; D014700:Verapamil / Q000008:administration & dosage / Q000627:therapeutic use*
D003692:Delayed-Action Preparations; D011433:Propranolol; D014700:Verapamil; D009543:Nifedipine