Failure of ketanserin, a serotonin inhibitor, to prevent spontaneous or ergonovine-induced attacks of variant angina.
Six patients hospitalized with active variant angina were treated for 3 days with the serotonin antagonist ketanserin after a 3 day control period on no medication. The number of variant angina episodes per patient per day was 1.52 +/- 1.42 during the control period and 2.05 +/- 2.30 during ketanserin therapy (p = NS). Ergonovine was administered in incremental doses of 0.0125 mg to 0.4 mg in the control period, during intravenous ketanserin administration and after 3 days of oral treatment. All 6 patients developed ST elevation during all 3 ergonovine tests. The ergonovine dose at which ST elevation developed was similar in each of the 3 periods. It is concluded that ketanserin is of no value in the treatment of variant angina and that both spontaneous and ergonovine-induced coronary spasm in man are unlikely to be mediated by a serotonergic mechanism.
Mata-Bourcart
L A
LA
Waters
D D
DD
Bouchard
A
A
Miller
D D
DD
Théroux
P
P
D000368:Aged; D000788:Angina Pectoris, Variant / Q000175:diagnosis / Q000188:drug therapy*; D003329:Coronary Vasospasm / Q000188:drug therapy; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography; D004874:Ergonovine; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D007650:Ketanserin; D008297:Male; D008875:Middle Aged; D010880:Piperidines / Q000627:therapeutic use*; D012702:Serotonin Antagonists / Q000627:therapeutic use*
D010880:Piperidines; D012702:Serotonin Antagonists; D007650:Ketanserin; D004874:Ergonovine