Isradipine therapy in chronic stable angina pectoris--comparison with nifedipine.
Current available calcium antagonists, although useful in angina pectoris, are often poorly tolerated. We therefore compared isradipine, a new calcium antagonist, with nifedipine in 18 patients with angina. Patients sequentially received incremental doses of either isradipine (IS) 2.5-7.5 mg three times daily or nifedipine (NF) 10-30 mg three times daily for 6 weeks each, in a randomized double-blind crossover study. Both agents produced similar (P = 0.43) increases in maximum exercise duration (IS + 30%; NF + 34%) and an equivalent (P = 0.38) increase in time to onset of angina on exercise (IS + 53%; NF + 62%). Both IS and NF significantly reduced exercise-induced ST depression (-40% and -45%) to a similar degree (P = 0.48). NF significantly (P = 0.019) reduced angina attacks (-3.0 attacks.week-1; 26%) compared to IS (-0.4; 4%) whilst a similar but non-significant trend in favour of NF was also apparent in the consumption of sublingual glyceryl trinitrate (-0.1 tablets.week-1; 2% vs +1.3.week-1; 23%; P = 0.28). However, significantly (P less than 0.03) more patients experienced adverse events whilst taking NF than with IS (36 events in 16/18 (89%) v 18 in 9/18 (50%). Thus, IS and NF increased exercise tolerance and reduced exercise angina and ST depression equally well although NF use was associated with fewer anginal episodes and IS with fewer side effects.
Currie
P
P
Department of Cardiology, Royal Liverpool Hospital, U.K.
Saltissi
S
S
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004334:Drug Administration Schedule; D004562:Electrocardiography; D005080:Exercise Test; D006439:Hemodynamics; D006801:Humans; D017275:Isradipine; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011725:Pyridines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D002121:Calcium Channel Blockers; D011725:Pyridines; D009543:Nifedipine; D017275:Isradipine