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Antianginal efficacy of perhexiline maleate in patients refractory to beta-adrenoreceptor blockade.

Abstract
We performed a double-blind controlled crossover trial of perhexiline maleate versus identical placebo in daily doses of 100-400 mg in 20 male patients who were severely limited with angina pectoris despite therapy with beta-adrenoreceptor blockers. All patients had documented coronary artery disease and were awaiting coronary artery bypass grafting. Beta-blocker therapy was continued unchanged. A significant response compared to placebo was evident after 100 mg of perhexiline, and incremental therapeutic effects were evident up to 400 mg. The mean weekly angina rate fell from 18.2 +/- 2.8 basal to 6.2 +/- 1.5 on 200 mg (P less than 0.05) to 2.8 +/- 0.9 on 400 mg perhexiline (P less than 0.05). Nitroglycerin consumption fell in parallel. The mean exercise duration increased from 261 +/- 57 sec to 384 +/- 75 sec (P less than 0.05). Five patients became asymptomatic on perhexiline, and the number of pain-free days increased 100% (P less than 0.01) compared to placebo. No patient experienced hypotension or heart failure. This study shows that the addition of perhexiline to beta-adrenoreceptor antagonists in patients with severe angina pectoris is effective and represents an alternative therapy.
AuthorsH D White, J B Lowe
JournalInternational journal of cardiology (Int J Cardiol) Vol. 3 Issue 2 Pg. 145-55 (May 1983) ISSN: 0167-5273 [Print] Netherlands
PMID6134684 (Publication Type: Journal Article)
Chemical References
  • Adrenergic beta-Antagonists
  • Piperidines
  • perhexiline maleate
  • Perhexiline
Topics
  • Adrenergic beta-Antagonists (pharmacology, therapeutic use)
  • Adult
  • Aged
  • Angina Pectoris (drug therapy)
  • Double-Blind Method
  • Drug Resistance
  • Humans
  • Male
  • Middle Aged
  • Perhexiline (analogs & derivatives, therapeutic use)
  • Piperidines (therapeutic use)

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