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[Anti-angina effect of amiodarone in therapy-resistant angina pectoris]
B J Meyer1, S Gschwend, B Marx
1Departement für Innere Medizin, Universitätsspital Zürich.
Insights
Amiodarone effectively reduced angina symptoms in patients with stable angina NYHA III, even when on triple therapy. This antianginal agent improved exercise duration and reduced cardiac strain indicators.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Stable angina pectoris (NYHA III) significantly impacts quality of life.
- Conventional triple therapy (nitrates, beta- and calcium entry blockers) may not fully alleviate symptoms.
- Coronary artery bypass grafting (CABG) is a treatment option for refractory angina.
Purpose of the Study:
- To evaluate the additional antianginal effect of amiodarone.
- To assess amiodarone's efficacy in patients with limiting angina on triple therapy.
Main Methods:
- Double-blind, randomized trial.
- 63 patients on CABG waiting list with stable angina NYHA III and positive stress test.
- 2-month study period comparing amiodarone addition to triple therapy versus placebo.
Main Results:
- The amiodarone treatment group showed increased exercise duration.
- A decrease in double product (heart rate x systolic blood pressure) was observed.
- Reduced ST-segment depression on stress testing indicated improved myocardial oxygen supply/demand balance.
Conclusions:
- Amiodarone demonstrates significant antianginal efficacy.
- It provides additional benefit for patients with limiting angina refractory to conventional triple therapy.
- Amiodarone is a viable therapeutic option for this patient population.
Abstract:
In a double-blind randomized trial 63 patients on the waiting list for coronary artery bypass grafting, with stable angina NYHA III and a positive stress test on triple (nitrates, beta- and calcium entry blockers) combination therapy, were studied for an additional antianginal effect of amiodarone over a period of 2 months. In the treatment group an increase in exercise duration and a decrease of the double product and of ST-depression were noted. Thus, amiodarone is an effective antianginal agent in patients with limiting angina pectoris on conventional triple therapy.