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[Diltiazem in chronic stable angina]
Insights
Diltiazem effectively reduced angina frequency and improved exercise capacity in patients with chronic stable angina. This study demonstrates diltiazem
Area of Science:
- Cardiology
- Pharmacology
Background:
- Chronic stable angina is a common manifestation of ischemic heart disease.
- Current treatments aim to improve symptoms and exercise tolerance.
Purpose of the Study:
- To evaluate the safety and efficacy of diltiazem in patients with chronic stable angina.
- To determine the dose-response relationship of diltiazem on angina frequency and exercise capacity.
Main Methods:
- A single-blind, dose-escalation study was conducted in 10 patients with documented ischemic heart disease.
- Patients received diltiazem at doses of 120, 240, and 360 mg/day.
- A double-blind, randomized crossover phase further assessed the effects of 360 mg/day diltiazem.
Main Results:
- Diltiazem significantly reduced weekly angina frequency in a dose-dependent manner.
- Exercise duration and time to 1 mm ST depression during exercise were significantly increased with diltiazem.
- The time to onset of ischemia during exercise was prolonged with 360 mg/day diltiazem compared to placebo.
Conclusions:
- Diltiazem, at doses ranging from 120 to 360 mg/day, is an effective antianginal agent.
- The drug demonstrated a favorable safety profile with no significant adverse effects observed.
- Diltiazem improves exercise capacity and reduces ischemic events in patients with chronic stable angina.
Abstract:
The safety and efficiency of the administration of diltiazem was evaluated in 10 patients with class II-III chronic stable angina. All the patients had ischemic heart disease documented by coronary angiography and/or an abnormal exercise test. A dose related improvement in both frequency of angina and exercise capacity were obtained by diltiazem administered in increased doses using a single blind protocol. The weekly frequency of angina was reduced from 7.5 +/- 9.8 with placebo to 3.8 +/- 5.5, 1.1 +/- (p less than 0.05) and 0.7 +/- 0.9 (p less than 0.01) with doses of 120, 240 and 360 mg/day respectively. The exercise duration on treadmill was significantly increased from 8.5 +/- 3.6 to 10.6 +/- 3.7 min (p less than 0.05) with the 360 mg/day dose. The mean exercise time required to develop 1 mm ST depression was 6.1 +/- 3 min on placebo and was significantly delayed to 9.0 +/- 3.8 min (p less than 0.05) with the 240 mg/day dose and to 10.7 +/- 4.0 min with 360 mg (p less than 0.01). In a double blind randomized crossover phase, the time to the onset of ischemia during exercise was increased from 8.5 +/- 3.8 min with placebo to 11.05 +/- 2.8 min with 360 mg/day of diltiazem (p less than 0.01). Diltiazem in doses ranging from 120 to 360 mg/day is an effective antianginal agent with no significant adverse effects.