Verapamil therapy for Prinzmetal's variant angina: comparison with placebo and nifedipine.
This study was performed (1) to assess the efficacy and safety of verapamil in patients with variant angina, and (2) to compare verapamil and nifedipine in patients with this clinical syndrome. In 27 patients, placebo and verapamil were administered in a long-term randomized, and double-blind study of 9 months' duration. In comparison to placebo, verapamil reduced the frequency of angina, nitroglycerin usage, transient episodes of electrocardiographic S-T segment deviation (as assessed by 2-channel Holter monitoring), and hospitalizations required for clinical instability. Subsequently, 23 patients were treated with nifedipine in a nonblind fashion for 2 months, and this agent exerted a beneficial effect similar to that of verapamil. Finally, gated equilibrium blood pool scintigraphy, performed in 10 patients at rest and during exercise during treatment with placebo, verapamil, and nifedipine, demonstrated that neither calcium antagonist caused a deterioration of left ventricular performance. Thus, (1) long-term oral verapamil and nifedipine are each superior to placebo and are of similar efficacy in patients with variant angina, and (2) neither agent adversely influences left ventricular performance in patients with relatively normal left ventricular function.
D000788:Angina Pectoris, Variant / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D001794:Blood Pressure / Q000187:drug effects; D003329:Coronary Vasospasm / Q000188:drug therapy*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D010919:Placebos / Q000627:therapeutic use*; D011725:Pyridines / Q000627:therapeutic use*; D013318:Stroke Volume / Q000187:drug effects; D014700:Verapamil / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
D010919:Placebos; D011725:Pyridines; D014700:Verapamil; D009543:Nifedipine