[Anti-angina effect of the calcium antagonist bepridil in stable angina pectoris]

Twelve patients with angiographically proven coronary artery disease and stable, exercise-induced angina pectoris were treated in a randomized sequence with placebo (PL) and bepridil tablets in maintenance doses of 200 mg, 400 mg and 600 mg per day for one week each, according to a double blind-protocol with intra-individual cross-over. The four treatment phases were separated by 2-week wash-out periods (placebo). On day 7 of each treatment phase and at the end of each wash-out period heart rate and blood pressure were measured 2 and 5 hours after drug intake and exercise stress testing was performed. The mean plasma concentrations at the end of the 1-week treatment periods 2 hours after drug intake were: 375 +/- 202 ng/ml (200 mg/day), 844 +/- 273 ng/ml (400 ng/day) and 1378 +/- 538 ng/ml (600 mg/day). Systolic blood pressure was not influenced by either bepridil dose. Diastolic blood pressure was slightly reduced (-6%) after 600 mg bepridil/day (p less than 0.05). While heart rate at rest in the upright position tended to lower values with regard to bepridil dosages, it was significantly lowered at the end of stress testing (2 hours/5 hours):400 mg: -7% (p less than 0.05)/-15% (p less than 0.05); 600 mg: -11% (p less than 0.001)/-10% (p less than 0.05). Myocardial ischemia (sum of ST-segment depressions) was improved in a dose-dependent manner (2 hours/5 hours):200 mg: -21% (p less than 0.05)/-31% (n.s.); 400 mg: -27% (n.s.)/-31% (p less than 0.01); 600 mg: -56% (p les than 0.001)/-55% (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)