Propranolol v. verapamil in the treatment of unstable angina. A double-blind cross-over study

European Heart Journal
A CapucciB Magnani

Abstract

A double-blind, cross-over study was performed in 23 consecutive patients with unstable angina at rest in order to compare the efficacy of verapamil (480 mg/day) and propranolol (240 mg/day) in reducing the number of anginal crises and nitroglycerin (NTG) consumption. Twenty patients, 15 men and five women, mean age 59.7 (range 45-68) years completed the study. The mean daily number of attacks was 3.1 in the two-day run-in period and 2.9 in a subsequent two-day placebo period immediately preceding the treatment periods. Propranolol reduced the number of attacks to 1.6 (P less than 0.01 compared to the run-in and placebo periods). Verapamil reduced the crises to 0.2/day (P less than 0.01 compared to the run-in placebo and propranolol periods). The NTG consumption behaved in a similar way. Adverse reactions to verapamil were observed in two patients. Although there are objective difficulties in performing correct trials in these kinds of patients, the results of this study indicate the efficacy of verapamil in preventing anginal pains during the "warm phase' of the unstable form and stress the superiority of this calcium antagonist when compared to propranolol.

Related Concepts

Related Feeds

Bradyarrhythmias

Bradyarrhythmias are slow heart rates. Symptoms may include syncope, dizziness, fatigure, shortness of breath, and chest pains. Find the latest research on bradyarrhythmias here.

Cardiology Journals

Discover the latest cardiology research in this collection of the top cardiology journals.

Antianginal Drugs: Mechanisms of Action

Antianginal drugs, including nitrates, beta-blockers, and calcium channel blockers, are used in the treatment of angina pectoris. Here is the latest research on their use and their mechanism of action.