PMID: 6969985Jan 1, 1981Paper

Nifedipine in the treatment of unstable angina, coronary spasm and myocardial ischemia

The American Journal of Cardiology
P G HugenholtzR W Brower

Abstract

The effects of nifedipine, a potent calcium antagonist, were studied in patients with unstable angina, coronary spasm and myocardial ischemia. Data from two separate groups of patients studied in the cardiac catheterization laboratory indicate that intracoronary injection of nifedipine promptly reversed coronary spasm--whether provoked or spontaneous--in five of six patients. In other patients, direct intracoronary injection of the drug was compared with intravenous administration. After intracoronary injection, local mechanical cardiac action virtually ceased, and the ventricular wall became thinner during systole. Thus, a specific inhibitory action on contractile energy expenditure could be demonstrated in the presence of increased coronary flow. This "oxygen-sparing" effect was tested in a group of 31 patients with symptomatic unstable angina whose pain at rest, with ST-T changes, had not responded to 8 hours of treatment with maximal beta adrenergic blockade, nitrates and bed rest. The addition of 6 X 10 mg of nifedipine rendered 27 of these patients asymptomatic within 1.5 hours. In the four patients who did not respond, coronary arteriography demonstrated severely stenotic lesions. Two of the four patients subsequently re...Continue Reading

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Citations

Sep 1, 1988·Cardiovascular Drugs and Therapy·C W Hamm, W Bleifeld
Jan 1, 1990·European Journal of Clinical Pharmacology·W Bleifeld
Jan 1, 1988·Cardiovascular Drugs and Therapy·E ThaulowJ Ross
Dec 1, 1987·Cardiovascular Drugs and Therapy·S Yusuf, C D Furberg
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Jul 1, 1986·The American Journal of Cardiology·S TerrisB Pitt
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Feb 1, 1986·Clinical Cardiology·M Y FlugelmanM S Gotsman
Jan 1, 1988·Annals of the New York Academy of Sciences·P G Hugenholtz

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