Comparison of the time to onset of action on myocardial ischaemia following intravenous administration of isosorbide dinitrate and 5-isosorbide mononitrate in Chinese patients.

Abstract

OBJECTIVE:

The onset of action of intravenous isosorbide dinitrate (CAS 87-33-2, ISDN) and intravenous 5-isosorbide mononitrate (CAS 16051-77-7, 5-ISMN) were compared by measurement of the indicators of perfusion to ischaemic myocardium.

METHODS:

Twenty-five patients with coronary heart disease were randomly allocated to receive intravenous ISDN or 5-ISMN. The extent of myocardial ischaemia before infusion and at 3, 15 and 45 min after commencement of infusion was evaluated using 99mTc-MIBI myocardium tomography imaging and electrocardiograms.

RESULTS:

The perfusion defects were significantly reduced or resolved in 11 patients (84.1%) receiving ISDN and 2 patients (15.38%) receiving 5-ISMN at 3 min. At 15 min the improvement was significantly greater in the ISDN group than in the 5-ISMN group. The improvements of 99mTc-MIBI myocardial uptake ratio and electrocardiograms were statistically significant in the ISDN group at 3 min and 15 min compared to pre-infusion. Although a significant improvement appeared at 15 min in the 5-ISMN group, it was significantly less than that observed in the ISDN group (p < 0.05). After 45 min, there were improvements in ischaemia in both groups with the difference compared to pre-infusion being significant, and there was no statistically significant difference between the ISDN and 5-ISMN group.

CONCLUSION:

In patients with coronary heart disease with ischaemic episodes the onset of therapeutic activity was more rapid with intravenous ISDN compared to 5-ISMN. ISDN should be the preferred intravenous nitrate for acute ischaemic episodes where a rapid onset of therapeutic action is desired.

• Authors: Zong-gui Wu, Jian-nan Li, Ming Fan, Yu-kun Shang, Ya-wen Zhang, Jin Bai, Ru Ding, Jing-Ming Cheng, Chun Liang
• Journal: Arzneimittel-Forschung (Arzneimittelforschung) Vol. 54 Issue 5 Pg. 275-9 ( 2004) ISSN: 0004-4172 [Print] Germany
• PMID: 15212189 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial)

Chemical References

• Radiopharmaceuticals
• Vasodilator Agents
• Technetium Tc 99m Sestamibi
• Isosorbide Dinitrate
• isosorbide-5-mononitrate

Topics

• Acute Disease
• Aged
• Electrocardiography (drug effects)
• Female
• Humans
• Injections, Intravenous
• Isosorbide Dinitrate (administration & dosage, analogs & derivatives, pharmacokinetics, therapeutic use)
• Male
• Middle Aged
• Myocardial Ischemia (diagnostic imaging, drug therapy)
• Radiopharmaceuticals
• Technetium Tc 99m Sestamibi
• Tomography
• Tomography, Emission-Computed
• Vasodilator Agents (administration & dosage, pharmacokinetics, therapeutic use)