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[Randomized comparison between gallopamil and diltiazem in angiography verified coronary heart disease]
1Herz-Kreislauf-Zentrum Gross Gerungs, NO.
Insights
Gallopamil significantly reduced angina frequency and nitroglycerin use in patients with coronary artery disease. This calcium channel blocker improved exercise tolerance and reduced ischemic index compared to diltiazem.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary artery disease (CAD) affects millions globally, necessitating effective therapeutic options.
- Calcium channel blockers are a cornerstone in managing CAD symptoms and improving exercise tolerance.
Purpose of the Study:
- To compare the efficacy of gallopamil versus diltiazem in patients with confirmed coronary artery disease.
- To evaluate the impact of these drugs on anginal frequency, nitroglycerin consumption, and exercise parameters.
Main Methods:
- A randomized study involving 30 patients with CAD, divided into gallopamil (15 patients) and diltiazem (15 patients) groups.
- Patients received either gallopamil (180 mg/day) or diltiazem (150 mg/day) after a 48-hour nitrate run-in period.
- Efficacy was assessed by monitoring anginal frequency, nitroglycerin use, exercise tolerance, blood pressure, heart rate, and ischemic index.
Main Results:
- Gallopamil therapy led to a significant reduction in weekly anginal frequency (10 ± 8 to 3 ± 2, p < 0.001).
- Nitroglycerin consumption decreased significantly (1.4 ± 1.4 to 0.3 ± 0.6, p < 0.001) with gallopamil.
- Gallopamil also improved exercise tolerance (740 ± 610 to 1140 ± 670, p < 0.01) and reduced the ischemic index (63 ± 24 to 46 ± 17, p < 0.01).
Conclusions:
- Gallopamil demonstrates significant efficacy in managing symptoms of coronary artery disease.
- The findings suggest gallopamil is a valuable therapeutic option for patients with CAD, offering improvements in exercise capacity and symptom relief.
Abstract:
In a randomized study 30 patients (age 59 +/- 7) with angiographically confirmed coronary artery disease were treated with either gallopamil (15 patients) or diltiazem (15 patients). After a 48-h-run-in period of treatment with nitrates the gallopamil group was treated with 3 X 60 mg/day, and the diltiazem group was treated with 3 X 50 mg diltiazem/day. As criteria for the efficacy of therapy the anginal frequency, the nitroglycerin consumption, and exercise tolerance were monitored. During exercise the blood pressure in the 50-watt-level, the product of blood pressure, and pulse rate at 50 watts and at the maximal workload level, the ischemic index was calculated as the product of blood pressure, pulse rate, and ST-segment depression/Watt. Later the exercise tolerance and the difference of the exercise tolerance before and after the drug period was measured. The following parameters improved under gallopamil therapy: the gallopamil group showed a significant reduction of the anginal frequency/week (10 +/- 8 down to 3 +/- 2, p less than 0.001), the nitroglycerin consumption (1.4 +/- 1.4 down to 0.3 +/- 0.6, p less than 0.001), the ischemic index (from 63 +/- 24 down to 46 +/- 17, p less than 0.01), and the exercise tolerance (740 +/- 610 up to 1140 +/- 670, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)