[Anti-ischemia effect of continuous 24-hour infusion of glyceryl trinitrate in patients with stable angina pectoris].
In a placebo-controlled, double-blind trial with intraindividual changes in a randomized sequence, 12 patients received either glyceryl trinitrate (Perlinganit), 3 mg/h, or a placebo (physiological saline) via a perfusion system continuously for 24 hours. All had been shown to have angiographically demonstrated coronary heart disease, stable angina and exercise-inducible ischaemia reaction in the electrocardiogram (ST-segment depression). The ischaemia reaction in the exercise ECG (sum of ST-segment depressions) 90 min after onset of the infusion was improved by a mean of 45% during glyceryl trinitrate compared with the placebo response (P less than 0.001). At the end of the 24-hour period of infusion, however, no significant anti-ischaemic effect was any longer demonstrable (diminution of the ischaemia reaction by 15%). The glyceryl trinitrate-induced effect, after 90 min infusion, on arterial systolic pressure (-14%; P less than 0.01) and heart rate (+17%; P less than 0.001) during standing, was also no longer demonstrable after the 24-hour infusion. Thus the haemodynamic and antiischaemic effects of glyceryl trinitrate in the described dosage were largely absent after continuous 24-hour intravenous infusion. The causes of this rapid loss of effect are most likely to be sought in counter regulatory events, e.g. activation of neurohumoral mechanisms.
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000517:prevention & control*; D004311:Double-Blind Method; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage* / Q000009:adverse effects; D005082:Physical Exertion; D011897:Random Allocation; D013997:Time Factors
D005996:Nitroglycerin
Antiischämische Wirkung einer 24stündigen kontinuierlichen Infusion mit Glyceryltrinitrat bei Patienten mit stabiler Angina pectoris.