Nicardipine treatment has been evaluated in patients with chronic stable effort angina or with
angina at rest due to coronary
spasm. Acute studies in patients with effort angina suggest a very favorable hemodynamic profile characterized by coronary vasodilatation and reduction in determinants of myocardial
oxygen demand. Both open and controlled trials in patients with effort angina show that long-term
oral administration increases exercise time and time to onset of 1 mm ST-segment depression and decreases angina frequency. With treatment for up to 6 months, antiischemic effects were maintained without serious adverse reactions. Other studies indicate that
nicardipine is generally comparable to
propranolol and
nifedipine in prolonging exercise time and time to onset of ST-segment depression.
Nicardipine, however, does not depress heart rate at rest, and maximal exercise workload is higher with
nicardipine than with either placebo or
propranolol. In a controlled study of patients with
angina at rest due to coronary
spasm,
nicardipine decreased angina frequency and
nitroglycerin consumption by approximately 80%. Episodes of symptomatic and asymptomatic ST-segment shift, as recorded by ambulatory electrocardiographic monitoring, showed a trend to decrease in number.
Nicardipine appeared similarly effective in patients with coronary
spasm superimposed on significant
coronary disease and with
spasm in the absence of significant
coronary disease.
Nicardipine appears to be safe and effective in the management of patients with
angina pectoris.