title: Antianginal efficacy of the combination of felodipine-metoprolol 10/100 mg compared with each drug alone in patients with stable effort-induced angina pectoris: a multicenter parallel group study. The TRAFFIC Study Group.
abstract: OBJECTIVE
  The primary objective of this randomized, double-blind, parallel group trial was to compare the antianginal and antiischemic efficacy of a combination tablet of felodipine-metoprolol 10/100 mg once daily with both drugs given separately once daily in patients with stable effort-induced angina pectoris. The secondary objective was to compare the tolerability of the 3 treatments.
  
  
  METHODS
  The main criteria for inclusion were stable effort-induced angina pectoris for at least 2 months before the enrollment and a positive bicycle exercise test result. Patients were allocated to once-daily treatment with either felodipine-metoprolol 10/100 mg, felodipine 10 mg, or metoprolol 100 mg. The duration of active double-blind treatment was 4 weeks. There were 3 primary efficacy variables in the study; time until end of exercise, time until onset of chest discomfort, and time until 1-mm ST depression during a standardized exercise test.
  
  
  RESULTS
  The number of patients randomized was 397. There was a statistically significant improvement in time until end of exercise with felodipine-metoprolol 10/100 mg compared with metoprolol 100 mg (P =.04) and felodipine 10 mg compared with metoprolol 100 mg ( P =.03). However, for time until onset of pain or time until 1-mm ST-depression there were no significant differences among the treatment groups. At highest comparable workload, ST depression was less pronounced with felodipine-metoprolol than with metoprolol alone (P =.04), and the rate-pressure product was significantly lower in the groups receiving felodipine-metoprolol and metoprolol than in the group receiving felodipine alone. The combination and metoprolol were better tolerated than felodipine alone.
  
  
  CONCLUSIONS
  In stable angina pectoris, the combination felodipine-metoprolol 10/100 mg and felodipine 10 mg alone increased exercise time compared with metoprolol 100 mg. The combination tablet and metoprolol 100 mg alone showed a more favorable tolerability profile than felodipine 10 mg alone.
authors.affiliation: Sahlgrenska Hospital, Göteborg, Sweden.
authors.forename: H
authors.initials: H
authors.lastname: Emanuelsson
authors.forename: K
authors.initials: K
authors.lastname: Egstrup
authors.forename: K
authors.initials: K
authors.lastname: Nikus
authors.forename: J
authors.initials: J
authors.lastname: Ellström
authors.forename: T
authors.initials: T
authors.lastname: Glud
authors.forename: C
authors.initials: C
authors.lastname: Pater
authors.forename: M
authors.initials: M
authors.lastname: Scheibel
authors.forename: A
authors.initials: A
authors.lastname: Tisell
authors.forename: K J
authors.initials: KJ
authors.lastname: Tötterman
authors.forename: M
authors.initials: M
authors.lastname: Forsby
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy* / Q000209:etiology; D002121:Calcium Channel Blockers / Q000627:therapeutic use*; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005080:Exercise Test / Q000009:adverse effects; D017079:Exercise Tolerance / Q000187:drug effects; D015736:Felodipine / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008790:Metoprolol / Q000627:therapeutic use*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D008790:Metoprolol; D015736:Felodipine