Related Experiment Videos
[Gallopamil infusion for treatment of Prinzmetal angina]
R Carlon1, F Cappelletti, R Ometto
1Divisione Cardiologica, Ospedale Civile, Cittadella.
Insights
Gallopamil effectively reduced anginal attacks and ischemic episodes in Prinzmetal variant angina patients. This new calcium channel blocker demonstrated significant efficacy in a small patient cohort.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Prinzmetal variant angina is characterized by recurrent chest pain due to coronary artery spasms.
- Effective management of vasospastic angina remains a clinical challenge.
Purpose of the Study:
- To evaluate the efficacy of gallopamil, a novel calcium channel blocker, in treating Prinzmetal variant angina.
- To assess the impact of gallopamil on anginal attacks and myocardial ischemic episodes.
Main Methods:
- A single-blind, self-controlled study with a placebo crossover was conducted in 9 patients with Prinzmetal variant angina.
- Gallopamil was administered intravenously, followed by Holter monitoring during treatment and withdrawal phases.
Main Results:
- Gallopamil significantly reduced anginal attacks by -63% to -91% during treatment.
- A statistically significant reduction in silent (-98%) and symptomatic (-93%) ischemic episodes was observed.
- Complete suppression of ischemic episodes occurred in 78% of patients by the third day of treatment.
Conclusions:
- Gallopamil demonstrates potent efficacy in suppressing anginal attacks and ischemic episodes in Prinzmetal variant angina.
- The drug shows promise as a therapeutic option for patients suffering from vasospastic angina.
Abstract:
The efficacy of a new calcium channel blocker, gallopamil, has been tested via a single blind, self-controlled versus placebo protocol in 9 consecutive patients admitted to our Coronary Care Unit because of repeated daily attacks of Prinzmetal variant angina. Exclusion criteria were age (greater than 65 years) bradycardia (less than 50 beats/min), recent myocardial infarction, heart failure, sinoatrial or atrioventricular block. After a 24 hours run-in period on saline drip, gallopamil was administered as 0.03 mg/kg bolus followed by continuous infusion at 0.02 mg/kg/h for the first 24 hours and 0.03 mg/kg/h for the last 48 hours. Treatment was then stopped and the patients were again kept on saline infusion for the next 30 hours. Holter monitoring was recorded during run-in, on third day of treatment and 6 hours after gallopamil withdrawal. Anginal attacks were significantly reduced in number by therapy (-63%, -91%, -84% in the 3 days of treatment). Holter monitoring during gallopamil infusion showed a statistically significant reduction in silent (-98%) and symptomatic (-93%) ischemic episodes (IE). During the last 24 hours of the washout period we observed a statistically significant increase in silent ischemic episodes. While no transient ST segment elevation was recorded in 3 patients, in 1 patient symptomatic IE were increased of 150% with respect to the run-in period. On the whole we observed complete suppression of IE in 7 patients (78%) at the third day of treatment with gallopamil. In 2 patients (22%) a greater than 75% reduction was observed.(ABSTRACT TRUNCATED AT 250 WORDS)