Effects of treatment with once-daily nifedipine CR and twice-daily benidipine on prevention of symptomatic attacks in patients with coronary spastic angina pectoris-Adalat Trial vs Coniel in Tokyo against Coronary Spastic Angina (ATTACK CSA).
BACKGROUND
We compared the efficacy of once-daily treatment with nifedipine CR 40 mg (NR) and twice-daily treatment with benidipine 4 mg (BD) in patients with coronary spastic angina (CSA) registered in 3 cardiovascular institutes in Tokyo.


RESULTS
CSA was diagnosed by an ischemic ST change during Holter ECG monitoring or drug-induced test. Thirty patients were randomly allocated to either NR or BD group. The number of symptomatic attacks and the total frequency of short-acting nitrates were examined based on the data in diaries written by patients. There were no significant differences in the baseline characteristics between the two groups. The median number (25-75% quartile) of attacks per week was significantly decreased in NR group, i.e., 1.0 (0.8-2.0) at baseline, 0.0 (0.0-1.0) after 4 weeks of treatment, and 0.0 (0.0-0.0) after 8 weeks of treatment (P=0.0093, P=0.0002, Wilcoxon's rank-sum test). No significant decrease was observed in BD, i.e. 1.0 (0.5-2.0) at baseline, 1.3 (0.0-3.0) after 4 weeks, and 0.0 (0.0-1.0) after 8 weeks. The number of attacks was fewer in NR than in BD group (P=0.074, P=0.015, U-test for difference).


CONCLUSIONS
Once-daily treatment with NR 40 mg was more effective than twice-daily treatment with BD in the prevention of CSA attacks.
Oikawa
Yuji
Y
Cardiovascular Department, The Cardiovascular Institute Hospital, 7-3-10 Roppongi Minato-ku, Tokyo, Japan. oikawa@cvi.or.jp
Matsuno
Syunsuke
S
Yajima
Junji
J
Nakamura
Masato
M
Ono
Tsuyoshi
T
Ishiwata
Sugao
S
Fujimoto
Yo
Y
Aizawa
Tadanori
T
D000109:Acetylcholine; D000787:Angina Pectoris / Q000517:prevention & control*; D001794:Blood Pressure / Q000187:drug effects; D003329:Coronary Vasospasm / Q000139:chemically induced / Q000517:prevention & control*; D004095:Dihydropyridines / Q000008:administration & dosage*; D015716:Electrocardiography, Ambulatory; D004874:Ergonovine; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000008:administration & dosage*; D009566:Nitrates / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000008:administration & dosage*
D004095:Dihydropyridines; D009566:Nitrates; D014665:Vasodilator Agents; C061004:benidipine; D009543:Nifedipine; D000109:Acetylcholine; D004874:Ergonovine