Assessment of the efficacy, optimal dosage, and safety of diltiazem in early treatment of unstable angina pectoris.

Abstract

BACKGROUND:

The anti-ischemic benefits of diltiazem are well recognized; however, there are fewer studies of the use of intravenous diltiazem for early treatment of unstable angina pectoris (UAP).

HYPOTHESIS:

The present study prospectively evaluated the efficacy, optimal dosage, and safety of continuous intravenous diltiazem for initial management of UAP.

METHODS:

In all, 102 patients with UAP were recruited in this multicenter trial. Diltiazem was administered as a continuous intravenous infusion with a fixed incremental dosage of 1,3, and 5 microg/kg/min, titrated according to the patients' symptoms of angina, and then was maintained for a further 48 h at the angina-free dose. Episodes of angina, hemodynamic stability, and complications were observed.

RESULTS:

Angina was adequately controlled with continuous intravenous infusion of diltiazem in 64 patients (63%) at a dosage of 1 microg/kg/min, in 26 patients (25%) at dosage of 3 microg/kg/ min, and in 6 patients (6%) at dosage of 5 microg/kg/min, leading to a cumulative effective ratio of 94% in all patients. Additional anti-ischemic medications were required in six patients (6%) who had refractory angina. Bradyarrhythmias noted in only six patients (6%) were reversible after decreasing the dosage of diltiazem. No acute myocardial infarction or other severe side effects occurred.

CONCLUSION:

Continuous intravenous infusion of diltiazem is well tolerated and relieves symptoms rapidly and effectively in up to 94% patients with UAP, with the majority (63%) treated at the low dosage of 1 microg/kg/min. Diltiazem can be used as a first-line anti-ischemic agent for early conservation treatment of UAP.

• Authors: Rong Bai, Diltiazem Clinical Trial Task Group of Wuhan
• Journal: Clinical cardiology (Clin Cardiol) Vol. 28 Issue 7 Pg. 343-8 (Jul 2005) ISSN: 0160-9289 [Print] United States
• PMID: 16075828 (Publication Type: Clinical Trial, Journal Article, Multicenter Study)

Chemical References

• Calcium Channel Blockers
• Diltiazem

Topics

• Aged
• Angina, Unstable (drug therapy)
• Blood Pressure (drug effects)
• Calcium Channel Blockers (administration & dosage, adverse effects, therapeutic use)
• Diltiazem (administration & dosage, adverse effects, therapeutic use)
• Dose-Response Relationship, Drug
• Female
• Heart Rate (drug effects)
• Humans
• Infusions, Intravenous
• Male
• Myocardial Infarction (prevention & control)
• Prospective Studies
• Treatment Outcome