Chronic effects of transdermal nitroglycerin in stable angina pectoris: a within-patient, placebo-controlled study.
The efficacy of transdermal nitroglycerin patches, releasing 20 mg of active substance over a period of 24 h (TDN 20), was investigated in 10 patients with stable exercise-induced angina pectoris. The study was divided into 3 periods: the first part was an acute, within-patient, crossover, double-blind, placebo-controlled study, in which patients performed a cycloergometric exercise test 4 and 24 h after the application of the patches (TDN 20 or placebo). During the 2nd period, patients were given TDN 20, in single blind conditions, for 4 weeks and another exercise test was performed, on the last day, 4 and 24 h after patch application. Finally, after a one-day placebo wash-out, a second acute study similar to the first was performed. Four h after dosing, exercise duration to 1 mm ST segment depression was 441 s and 314 s (p less than 0.01) for TDN 20 and placebo, respectively (first acute study), 394 s for TDN 20 after chronic treatment (p less than 0.001 vs acute placebo) and 472 and 354 s (p less than 0.001) for TDN 20 and placebo, respectively (second acute study). No difference in exercise duration to 1 mm ST segment depression was found between TDN 20 and placebo, 24 h after administration, in any of the periods. Blood pressure significantly decreased and heart rate significantly increased 4 h after TDN dosing (in comparison with placebo) in both the acute studies, but no difference was observed after chronic TDN treatment. In conclusion, TDN 20 increases exercise tolerance 4 h after the application of both acute and chronic treatments.(ABSTRACT TRUNCATED AT 250 WORDS)
Gibelli
G
G
Cardiological Dept, U.S.S.L. 58 - Cernusco sul Naviglio, Italy.
Negrini
M
M
Bruno
A M
AM
Fiorini
G L
GL
Lambiase
M
M
Magenta
G
G
Corti
D
D
Prina
L
L
Pollavini
P G
PG
De Ponti
C
C
D000279:Administration, Cutaneous; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects; D002908:Chronic Disease; D002986:Clinical Trials as Topic; D004311:Double-Blind Method; D004361:Drug Tolerance; D005080:Exercise Test; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D005996:Nitroglycerin / Q000008:administration & dosage / Q000627:therapeutic use*
D005996:Nitroglycerin