Dissociation of exercise tolerance and total myocardial ischemic burden in chronic stable angina pectoris

The American Journal of Cardiology
W E Shell, D Dobson

Abstract

Exercise treadmill tests and ambulatory monitoring were used in a double-blind, placebo-controlled, double-dummy crossover comparison of nifedipine (10 mg, 3 times daily) and transdermal nitroglycerin (15 mg). All patients (n = 20) had chronic stable angina with symptomatic and silent events. All patients had 3 episodes of angina/week and 3 episodes of ischemia/24 hr. The protocol was made up of 2 weeks of placebo followed by 2 weeks of active drug, then crossed over for 2 weeks of placebo followed by the other active drug. At the end of each 2-week period, patients had ambulatory monitoring and exercise treadmill testing. All ambulatory monitoring reports were read blind and entered into an independent data base. The results were the following: on transdermal nitroglycerin, the duration of ischemia decreased by 57% from 140 min/24 hr to 60 min/24 hr (p = 0.0054). The exercise time increased by 5.5% from 4.8 to 5.0 minutes (p = 0.16). With nifedipine, the duration of ischemia decreased by 22% from 175 min/24 hr to 137 min/24 hr (p = 0.16). The exercise tolerance time increased by 13% from 4.5 to 5.0 minutes (p = 0.0264). Nifedipine increased exercise time without altering total ischemic time, while transdermal nitroglycerin dec...Continue Reading

Citations

Aug 1, 1991·Journal of Clinical Pharmacology·D Rinde-HoffmanD K Arnett
Mar 1, 1996·Cardiovascular Drugs and Therapy·T O Klemsdal, K Gjesdal
Oct 1, 1994·Cardiovascular Drugs and Therapy·H PurcellK Fox
Aug 1, 1994·Cardiovascular Drugs and Therapy·U Thadani, R J Lipicky
Feb 1, 1993·Journal of the American College of Cardiology·E RossettiS L Chierchia
Sep 24, 1992·The American Journal of Cardiology·C J Pepine
Nov 1, 1992·International Journal of Cardiology·B TakaseT Kodaira
Jul 1, 1994·American Heart Journal·N J Mangione, S P Glasser

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