Efficacy of slow-release nifedipine on myocardial ischemic episodes in variant angina pectoris.

To evaluate the efficacy of slow-release nifedipine (a single dose of 20 mg given at 10 P.M. or 2 doses of 20 mg at 10 P.M. and 6 A.M.) on ischemic episodes in patients with variant angina, a single-blind crossover study with ambulatory electrocardiographic monitoring was performed in 15 patients (13 men and 2 women, mean age 63 years). In all, there were 646 ischemic episodes detected with ambulatory electrocardiographic monitoring during the study period, and 618 episodes of them occurred during placebo periods with a circadian variation. Sixty-nine percent of the episodes in placebo periods were asymptomatic. The number of anginal attacks, nitroglycerin tablets taken, ST-segment elevation and the total ischemic duration significantly decreased during nifedipine therapy compared with results after the placebo therapy period, respectively (p less than 0.01 or 0.05). Twenty-eight ischemic episodes occurred during nifedipine therapy when the plasma level of nifedipine was low. Thus, asymptomatic ischemic episodes more frequently occur than symptomatic episodes and the administration of slow-release nifedipine is highly effective in suppressing not only symptomatic but also asymptomatic myocardial ischemia in patients with variant angina. The timing of the administration of slow-release nifedipine is an important factor in suppressing ischemic episodes.
AuthorsY Morikami, H Yasue
JournalThe American journal of cardiology (Am J Cardiol) Vol. 68 Issue 6 Pg. 580-4 (Sep 1 1991) ISSN: 0002-9149 [Print] UNITED STATES
PMID1908630 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article)
Chemical References
  • Delayed-Action Preparations
  • Placebos
  • Nitroglycerin
  • Nifedipine
  • Aged
  • Aged, 80 and over
  • Angina Pectoris, Variant (drug therapy)
  • Circadian Rhythm
  • Coronary Disease (physiopathology)
  • Delayed-Action Preparations
  • Electrocardiography (drug effects)
  • Electrocardiography, Ambulatory
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction (physiopathology)
  • Nifedipine (administration & dosage, blood, therapeutic use)
  • Nitroglycerin (administration & dosage, therapeutic use)
  • Placebos
  • Single-Blind Method
  • Time Factors

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