[Combination therapy with slow release isosorbide nitrate and diltiazem in silent myocardial ischemia].
In 11 patients (2 female, 9 male) suffering from angiographically proven CHD (age 45-60 years; 54.3 years on an average) the efficacy of a once-daily oral medication with 120 mg ISDN/50 mg ISMN and diltiazem (D) each in a long-acting preparation was examined in a placebo-controlled study. Each period lasted for 3 days; 2 capsules were given at 0700 a.m. one capsule at 5 p.m. Long-term ECG-recordings for 24 hrs (Tracker recorder, Pathfinder III) were performed twice under placebo and once during the third day of ISDN or ISMN, ISDN/ISMN + D in the morning and JSDN or ISMN in the morning and D in the afternoon. The rate of ischemic events declined from 10.4 to 4.7, 3.3 and 2.2; the duration of ischemia in 24 hours declined from 128 min to 43 min, 44 min and 34 min. The product of ST-depression (mV) and time of duration (min) showed an equivalent course. A more than 80% reduction of ischemia (duration and frequency) was achieved by a combination therapy in 72% of the patients. Minimal increase of heart rate at the beginning of ST-depression increased significantly during all periods of therapy, maximal increase of heart rate at that time showed a decrease only during combination therapy with D, the mean value did not change significantly. The once-daily application of ISDN/ISMN (50 mg) in a long-acting preparation (120 mg) led to a significant reduction of silent myocardial ischemia. The efficacy of ISDN/ISMN can be improved by D (120 mg, long acting preparation) up to a greater than 80% reduction in frequency and duration of ischemic events.
Brisse
B
B
Medizinische Klinik und Poliklinik, Münster.
Behrenbeck
T
T
Ebert
U
U
Navah
R
R
Bender
F
F
D000328:Adult; D003327:Coronary Disease / Q000188:drug therapy*; D004110:Diltiazem / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D015716:Electrocardiography, Ambulatory; D005080:Exercise Test; D005260:Female; D006801:Humans; D007548:Isosorbide Dinitrate / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D004110:Diltiazem; D007548:Isosorbide Dinitrate; C030397:isosorbide-5-mononitrate
Kombinationstherapie mit retardiertem Isosorbidnitrat und Diltiazem bei stummer Myokardischämie.