[The acute and chronic effects of 10-mg nitroglycerin patches in stable angina of effort].
OBJECTIVE
To assess the anti-ischemic efficacy of nitroglycerin patches (10 mg/day), we studied, by means of serial exercise testing (Bruce protocol), 10 patients with stable effort angina in a randomized, placebo-controlled, cross-over, double-blind essay.


METHODS
Patients were exercised 1, 4, 12 and 24 hours after a single patch, and 4 and 12 hours after a 48 hours therapy course. Chronic therapy was assessed after both continuous and intermittent (intermission of 12 hours) patch application.


RESULTS
After single patch, time to angina and time to 1 mm ST depression were significantly increased with respect to placebo at 1-hour test (83 +/- 27 s and 119 +/- 39 s, respectively), 4-hour test (100 +/- 34 s and 87 +/- 29 s, respectively) and 12-hour test (46 +/- 15 s and 64 +/- 20 s, respectively). No effect was demonstrated at 24-hour test. After continuous treatment no differences with respect to placebo were found at any test. After intermittent treatment time to angina was prolonged (75 +/- 23 s) only at 4-hour test, and time to 1 mm ST depression at 4-hour test (61 +/- 19 s) and 12-hour test (41 +/- 14 s).


CONCLUSIONS
Nitroglycerin patches improve parameters of exercise ischemia for a 12 hours period. Tolerance is developed very early and provokes absolute lack of efficacy. Tolerance can be avoided with intermittent patch application. No treatment schedule shows 24 hours efficacy.
González Vílchez
F
F
Servico de Cardiología, Hospital Marqués de Valdecilla, Santander.
Ruano
J
J
San José
J M
JM
Vázquez de Prada
J A
JA
Martín Durán
R
R
López Somoza
C
C
Pajarón
A
A
D000279:Administration, Cutaneous; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage*; D005082:Physical Exertion / Q000187:drug effects*; D013997:Time Factors
D005996:Nitroglycerin
Estudio del efecto agudo y crónico de los parches de 10 mg de nitroglicerina en la angina de esfuerzo estable.