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Intermittent nitrate therapy for prior myocardial infaraction does not induce rebound angina nor reduce cardiac

K Ishikawa1, T Yamamoto, K Kanamasa

  • 1First Department of Medicine, Kinki University School of Medicine, Osakasayama, Osaka.

Internal Medicine (Tokyo, Japan)
|February 24, 2001
PubMed

Insights

Intermittent nitrate administration for ischemic heart disease is safe, as it does not cause rebound angina. This nitrate therapy regimen is a viable alternative to continuous administration for managing heart conditions.

Area of Science:

  • Cardiology
  • Pharmacology

Background:

  • Long-term nitrate therapy for ischemic heart disease can lead to drug tolerance.
  • Intermittent nitrate administration is recommended to mitigate tolerance.
  • Rebound angina during nitrate-free intervals is a potential concern with intermittent therapy.

Purpose of the Study:

  • To investigate the occurrence of rebound angina in patients switched from continuous to intermittent nitrate administration.
  • To evaluate the safety and efficacy of intermittent nitrate therapy in patients with prior myocardial infarction.

Main Methods:

  • Retrospective study of 606 patients with prior myocardial infarction.
  • Comparison of three groups: No-nitrate, Continuous nitrate administration, and Intermittent nitrate administration.
  • Mean observation period of 4.3 months.

Main Results:

  • No cases of rebound angina were observed in the intermittent nitrate group.
  • Cardiac events occurred in 0.3% (No-nitrate), 3.7% (Continuous), and 1.1% (Intermittent) of patients.
  • Continuous nitrate administration showed a significantly increased incidence of cardiac events compared to the no-nitrate group.

Conclusions:

  • Intermittent nitrate administration is safe and does not induce rebound angina.
  • The safety profile of intermittent nitrate therapy is comparable to no nitrate use.
  • Further randomized controlled trials are necessary to ascertain the long-term effects on cardiac events.
Abstract

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