[Isradipine versus diltiazem in the treatment of stable effort angina pectoris: ergometric evaluation in a crossover double-blind study].
OBJECTIVE
To evaluate the effects of isradipine (ISR) and diltiazem (DIL) on exercise tolerance and ischemic ST depression in patients with stable effort angina.


METHODS
Fourteen out-patients, 9 males and 5 females, aged 46-65 years (mean +/- SD = 57 +/- 8), with ischemic heart disease and reproducible ST-segment depression on two consecutive exercise stress tests in baseline conditions, underwent a study consisting of 4 periods: 1 and 3 placebo, 2 and 4 at random ISR (5 mg b.i.d.) and DIL (120 mg b.i.d.). At the end of each period a multistage treadmill exercise stress test (Bruce protocol) was performed.


RESULTS
Both drugs significantly (p < 0.001) increased ischemia time (IT) (0.1 mV ST depression) as compared to placebo, from 438 +/- 132 s. to 620 +/- 164 s. (ISR) and 583 +/- 147 s. (DIL) without statistical difference between two drugs (p = 0.2), and significantly reduced (p < 0.002) the maximal ST depression, from -0.20 +/- 0.11 mV to -0.07 +/- 0.07 mV (ISR) and -0.09 +/- 0.11 mV (DIL). At the IT, systolic blood pressure increased (p = 0.02), from 180 +/- 19 mm Hg to 187 +/- 15 mm Hg (ISR) and 191 +/- 15 mm Hg (DIL); similarly, heart rate increased from 133 +/- 24 bpm to 144 +/- 18 bpm (ISR: p = 0.002) and 140 +/- 17 bpm (DIL: p = NS).


CONCLUSIONS
ISR and DIL, at the above dosage have showed an important and significant anti-ischemic effect (IT = +41.5% during ISR and +33.1% during DIL).
Perticone
F
F
Dipartimento di Medicina Sperimentale e Clinica di Catanzaro, Università di Reggio Calabria.
Borelli
D A
DA
Maio
R
R
Costa
R
R
Pugliese
F
F
Torchia
L
L
Caristo
S
S
Mattioli
P L
PL
D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis / Q000188:drug therapy*; D018592:Cross-Over Studies; D004110:Diltiazem / Q000008:administration & dosage / Q000627:therapeutic use*; D004311:Double-Blind Method; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D017275:Isradipine / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D004110:Diltiazem; D017275:Isradipine
Isradipina versus diltiazem nella terapia della angina stabile da sforzo: valutazione ergometrica in crossover doppio cieco.