Anti-ischemic and antianginal effects of 60 mg isosorbide-5-mononitrate in patients treated chronically after myocardial infarction.
25 patients with stable angina pectoris after acute myocardial infarction were given single and maintenance doses of isosorbide-5-mononitrate (IS-5-MN) in a controlled-release formulation. For evaluation of the efficacy of this treatment, a score based on exercise tests and patient's complaints including additional antianginal medication were used 4 weeks after the acute event. For assessment of anti-ischemic effect non-invasive parameters including heart rate, arterial blood pressure, changes in ST segments, frequency of premature ventricular beats and systolic time intervals were used before medication, 5 h after the initial dose and 7 days after maintenance therapy. The therapeutic concept of interval treatment was found to be effective. Nitrate tolerance did not develop. Measurements of plasma levels under steady-state conditions revealed minimum values of 100 ng/ml and maximum levels of 460 ng/ml which is in between the threshold for anti-ischemic effect and development of nitrate tolerance, respectively.
Wrobel
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Medical Intensive Care Unit, Free University of Berlin.
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy* / Q000209:etiology; D003692:Delayed-Action Preparations; D004334:Drug Administration Schedule; D004361:Drug Tolerance; D015444:Exercise; D005260:Female; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000097:blood / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications*
D003692:Delayed-Action Preparations; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate