Comparative efficacy of the intravenous administration of linsidomine, a direct nitric oxide donor, and isosorbide dinitrate in severe unstable angina. A French multicentre study. French Group of Investigators.

Abstract

AIMS:

Although linsidomine shares common properties with nitrovasodilators, it releases nitric oxide directly without catalytic involvement by thiols. We conducted a prospective, randomized, multicentre, parallel group, single-blind study to compare the efficacy of intravenous administration of linsidomine with that of isosorbide dinitrate in unstable angina.

METHODS AND RESULTS:

Between November 1990 and July 1992, 568 patients with suspected unstable angina (class IIIB of the Braunwald classification) received a continuous infusion of either linsidomine (1 mg.h-1 on average) or isosorbide dinitrate (2.5 mg.h-1 on average) for 72 h. All patients received concomitant aspirin and intravenous heparin, 81% beta-blockers and 38% calcium antagonists. Holter monitoring was performed in all patients and analysed blindly. Only 25% of the patients had at least one episode of chest pain during the study (24.6% vs 25.8% in the linsidomine and isosorbide dinitrate groups, P = 0.74), of which 12% were associated with ECG changes. Holter criteria yielded similar results in both groups: 33% of patients presented episodes of myocardial ischaemia (32.6% vs 33.9% in the linsidomine and isosorbide dinitrate groups, P = 0.74), while 45% showed episodes of ventricular arrhythmia (43.5% vs 46.5% in the linsidomine and isosorbide dinitrate groups, P = 0.48). The incidence of serious clinical events at 72 h (death, myocardial infarction or myocardial revascularization) was 6.5% (5% vs 8% in the linsidomine and isosorbide dinitrate groups, P = 0.17).

CONCLUSION:

Intravenous linsidomine is at least as efficacious as isosorbide dinitrate in the stabilization of patients with severe unstable angina.

• Authors: J Delonca, T Giraud, P Beaufils, B Dupuis, R Haïat, C Théry
• Journal: European heart journal (Eur Heart J) Vol. 18 Issue 8 Pg. 1300-6 (Aug 1997) ISSN: 0195-668X [Print] England
• PMID: 9458423 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Vasodilator Agents
• Nitric Oxide
• linsidomine
• Molsidomine
• Isosorbide Dinitrate

Topics

• Aged
• Angina, Unstable (drug therapy)
• Confidence Intervals
• Electrocardiography, Ambulatory
• Female
• France
• Humans
• Isosorbide Dinitrate (therapeutic use)
• Male
• Middle Aged
• Molsidomine (analogs & derivatives, therapeutic use)
• Nitric Oxide
• Prospective Studies
• Single-Blind Method
• Statistics, Nonparametric
• Treatment Outcome
• Vasodilator Agents (therapeutic use)