Felodipine-induced dilatation of epicardial coronary arteries. A randomized, double-blind study

Dilatation of large coronary arteries is of potential value in the treatment of angina pectoris. In this double-blind study, the acute effect of felodipine or placebo on coronary artery dilatation was studied in patients with severe angina pectoris with the aid of coronary arteriography. There were two parallel groups, one with 9 patients who received felodipine, the other with 12 patients who received placebo. Measurements of vessel diameters were performed at a proximal position of the affected artery, at the site of the stenosis, and distal to the lesion. The mean plasma felodipine concentration was 17+/-6 nmol/l. The systolic blood pressure was reduced from 156+/-15 to 145+/-13 mm Hg after felodipine (p less than 0.05), but was unaffected by placebo. The heart rate and arterial catecholamine levels were basically unchanged in both groups of patients. The proximal arterial segment was dilated 7% after felodipine (p = 0.05), the stenosis area 9% (N.S.) and the distal part of the vessel 7% (p less than 0.05). There were no changes in coronary diameters in the placebo group. In conclusion, felodipine dilates large coronary arteries, and this mode of action may be valuable in the treatment of patients with coronary artery disease, especially in cases where coronary spasm is a prominent feature.