[Control of the effectiveness of nitrate therapy with long-term ECG based on spontaneous ST segment changes]

Area of Science:

• Cardiology
• Pharmacology

Background:

• Coronary artery disease (CAD) poses a significant health burden.
• Managing ischemic episodes is crucial for CAD patients.

Purpose of the Study:

• To evaluate the efficacy of Isosorbide dinitrate (ISDN) and Diltiazem in reducing ischemic episodes in CAD patients.
• To determine the threshold for confirming a true therapeutic effect considering intraindividual variability.

Main Methods:

• A study involving 40 patients with coronary artery disease.
• 24-hour Holter monitoring was conducted over three consecutive days.
• Patients received ISDN 120 mg or ISDN 120 mg plus Diltiazem 120 mg.

Main Results:

• Both ISDN 120 mg and the combination of ISDN 120 mg plus Diltiazem 120 mg significantly reduced overall ischemic episodes.
• A substantial intraindividual reduction of at least 97% in ischemic episodes was required to distinguish a true therapeutic effect from spontaneous day-to-day variability.

Conclusions:

• ISDN and Diltiazem show potential in managing ischemic episodes in CAD.
• Accounting for day-to-day variability is essential when assessing treatment efficacy in CAD patients.