Permutation distribution estimation applied to the comparison of the profile of the activity of two antianginal drugs.
The comparison of the anti-ischemic activity of trimetazidine and propranolol was evaluated by multiple end points (clinical, exercise test, and ambulatory electrocardiogram [ECG] monitoring criteria) in 149 male patients with effort angina who received either trimetazidine 20 mg tid or propranolol 40 mg tid during a period of 3 months. The distribution of the standardized differences between the two treatments for each variable was obtained by a permutation method. The medians (estimation of the actual difference between the two treatments) and the 5, 25, 75 and 95% quantiles were represented on the same diagram for all end points. The pattern of the standardized distribution of the differences showed a similar activity of both drugs on symptoms and nitrates consumption, on exercise tolerance and increase in ischemic threshold at exercise, and on ischemia recorded at ambulatory ECG monitoring. Conversely, only propranolol decreased heart rate and rate pressure product at rest as well as at exercise, underlining the difference in the mode of action of the two drugs. This descriptive technique is an attractive method to evaluate the differences between drugs considering multiple criteria favouring the estimation of these differences together with their variability.
Harpey
C
C
LBF, Scientific Direction, Neuilly-sur-Seine, Belgium.
Coker
S
S
Sellier
P
P
Maccario
J
J
Détry
J M
JM
D000787:Angina Pectoris / Q000188:drug therapy* / Q000503:physiopathology; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D015716:Electrocardiography, Ambulatory; D017079:Exercise Tolerance; D006801:Humans; D008297:Male; D008875:Middle Aged; D011433:Propranolol / Q000627:therapeutic use*; D014292:Trimetazidine / Q000627:therapeutic use*; D014665:Vasodilator Agents / Q000627:therapeutic use*
D014665:Vasodilator Agents; D011433:Propranolol; D014292:Trimetazidine