Usefulness of pirenzepine, an M1 antimuscarinic agent, for effort myocardial ischemia

The American Journal of Cardiology
P MarracciniA L'Abbate


This study evaluated the effect of pirenzepine, an M1 antimuscarinic agent, on exercise duration and ischemic threshold in patients with angiographically documented coronary artery disease and clear-cut ST depression (greater than 0.2 mV, 0.08 second after the J point) during ergometric stress testing. Twenty-five patients, mean age 56 +/- 8 years, underwent 3 randomized multistage bicycle exercise stress tests after intravenous administration of saline solution (2 ml), isosorbide dinitrate (1 mg) and pirenzepine (2 mg). Isosorbide dinitrate, an endothelium-independent coronary dilating agent, was used as a reference drug. Compared with saline, both pirenzepine and isosorbide dinitrate significantly improved time to ischemia (0.15 mV ST-segment depression) from 6.5 +/- 2 to 7.8 +/- 2 and 8.6 +/- 2 minutes and rate-pressure product at ischemia from 21,498 +/- 4,903 to 24,083 +/- 6,692 and 24,547 +/- 5,390 mm, respectively. Compared with saline, pirenzepine did not induce significant changes in blood pressure either at rest or during exercise, whereas it decreased resting heart rate from 71 +/- 9 to 60 +/- 11 beats/min (p less than 0.01) and induced a significant increment of heart rate during ischemia from 117 +/- 1...Continue Reading


Oct 12, 1989·The New England Journal of Medicine·R K Goyal
Jul 1, 1988·Naunyn-Schmiedeberg's Archives of Pharmacology·A Wellstein, H F Pitschner
Mar 1, 1988·Progress in Cardiovascular Diseases·E Bassenge, R Busse
Apr 15, 1986·The American Journal of Cardiology·Y HorioT Kimura
Oct 1, 1981·The American Journal of Cardiology·S E Epstein, T L Talbot

Related Concepts

Angina Pectoris
Diastolic Blood Pressure
Cardiopulmonary Exercise Test
Pulse Rate
Pirenzepin von ct

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