Cooling down unstable angina with high dosage of isosorbide dinitrate (ISDN) continuously infused

Area of Science:

• Cardiology
• Pharmacology

Background:

• Unstable angina is a critical cardiac condition requiring immediate management.
• Standard nitrate and calcium-antagonist therapies are often insufficient for severe cases.

Purpose of the Study:

• To evaluate the efficacy of intravenous isosorbide dinitrate (ISDN) infusion in controlling acute ischemic episodes in unstable angina.
• To assess the long-term outcomes of ISDN therapy in these patients.

Main Methods:

• Fifteen patients with refractory unstable angina received ISDN infusions, with dosages adjusted as needed.
• Electrocardiogram (ECG) changes and frequency of ischemic attacks were monitored.
• Patients were followed for up to 96 months post-discharge.

Main Results:

• 73% of patients experienced a significant reduction in ischemic episodes during ISDN infusion.
• Long-term follow-up showed 7 patients remained free of attacks, while 3 died.
• ISDN infusion provided a temporary but effective solution for managing acute ischemia.

Conclusions:

• Intravenous ISDN infusion is an effective strategy for managing the acute phase of unstable angina.
• This treatment can serve as a bridge to revascularization procedures like coronary bypass surgery or percutaneous transluminal coronary angioplasty (PTCA).
• A significant number of patients achieved complete resolution of ischemic attacks with this approach.