Treatment of silent ischemia in unstable angina: a randomized comparison of sustained-release verapamil versus metoprolol

Clinical Cardiology
N SinghA Langer

Abstract

Silent ischemia is a frequent finding in patients with unstable angina and portends a poor prognosis. We compared the efficacy of sustained-release (SR) verapamil and metoprolol in reducing silent ischemia in patients with unstable angina and assessed whether detection of silent ischemia was related to unfavorable outcomes in the contemporary setting of concurrent therapy with heparin and aspirin. Holter monitoring (leads a VF, V2, V5) for the first 72 h was used to assess the frequency and duration of ST-shift episodes. There were 37 patients in the verapamil-SR group and 40 patients in the metoprolol group, with both groups having similar baseline characteristics. There were more episodes of angina in the verampamil-SR group (29 vs. 12, p = 0.05). There was no difference between the two groups in the frequency (51 vs. 49 episodes, p = 0.9) or duration (23 +/- 48 vs. 18 +/- 50 min, p = 0.6) of ST-shift episodes. There were 20 unfavorable in-hospital outcomes distributed equally between the two groups (p = 0.9). Patients with unfavorable outcomes had ST shift more often (50 vs. 28%, p = 0.07) and for a longer duration (40 +/- 69 vs. 13 +/- 38 min, p = 0.03). Patients with ST shift > or = 60 min had a 60% probability of unfavora...Continue Reading

References

Sep 1, 1992·The American Journal of Cardiology·D W Grambow, E J Topol
Jan 1, 1989·Journal of Cardiovascular Pharmacology·H L Elliott
Jun 1, 1989·Journal of the American College of Cardiology·A LangerP W Armstrong
May 8, 1986·The New England Journal of Medicine·S O GottliebG Gerstenblith
Oct 27, 1988·The New England Journal of Medicine·P ThérouxP deGuise
Jul 1, 1987·Journal of the American College of Cardiology·K NademaneeB N Singh
Mar 1, 1985·Journal of the American College of Cardiology·P ThérouxD D Waters
Apr 15, 1982·The New England Journal of Medicine·G GerstenblithM L Weisfeldt
Oct 1, 1982·The American Journal of Cardiology·O ParodiA Maseri
Apr 1, 1980·The American Journal of Cardiology·M PrevitaliP Bobba
Mar 1, 1993·Current Problems in Cardiology·P Théroux, R M Lidón
Feb 1, 1994·Circulation·L L-LacosteD Waters

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Citations

Nov 11, 1998·Journal of the American College of Cardiology·N L SmithT D Koepsell
May 26, 1999·Current Problems in Cardiology·M FreherM Gheorgiade
Dec 17, 2009·International Journal of Methods in Psychiatric Research·Christopher G Hudson

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