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Effect of bepridil in patients with chronic stable angina: results of a multicenter trial
Insights
Bepridil, a calcium antagonist, significantly improved exercise tolerance and reduced angina symptoms in patients with exercise-induced angina pectoris. This study confirms bepridil
Area of Science:
- Cardiology
- Pharmacology
Background:
- Exercise-induced angina pectoris is a common condition.
- Calcium antagonists are a class of drugs used to treat angina.
Purpose of the Study:
- To assess the efficacy of bepridil in patients with exercise-induced angina pectoris.
Main Methods:
- Double-blind, randomized, placebo-controlled crossover trial.
- 44 patients with exercise-induced angina and ST segment depression.
- Modified Bruce protocol for exercise testing.
Main Results:
- Bepridil (400 mg daily) significantly increased total exercise time, time to angina onset, and time to ST segment depression (p ≤ .001).
- Reduced angina frequency and nitroglycerin consumption (p = .02 and .03).
- Minor side effects were reported; one death occurred during the bepridil phase.
Conclusions:
- Bepridil, 400 mg daily, is effective in treating exercise-induced myocardial ischemia and angina pectoris.
- Further research may be warranted to assess long-term safety and efficacy.
Abstract:
The effects of bepridil, a calcium antagonist with a half-life of approximately 42 hr, were assessed in a double-blind, randomized, placebo-controlled crossover trial. Forty-four patients (39 men, five women) with exercise-induced angina pectoris and ST segment depression with exercise testing (modified Bruce protocol) were studied. Compared with placebo bepridil (400 mg daily) increased total exercise time, time to onset of angina, time to 1 mm of ST segment depression, time to 2 mm of ST segment depression, and total work achieved (all p less than or equal to .001). Both frequency of angina and nitroglycerin consumption decreased during the bepridil compared with the placebo period (p = .02 and .03, respectively). Minor side effects were noted during both the bepridil and placebo phases. Four patients experienced side effects that limited therapy (dizziness in three and abnormal results of liver function tests in one) and one patient died during the bepridil phase. This study suggests that bepridil, 400 mg daily, is effective for the treatment of exercise-induced myocardial ischemia and angina pectoris.