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[Use of verapamil for treating patients with unstable stenocardia]
Insights
Verapamil effectively reduced angina in over 60% of patients with unstable angina. Long-term use is tolerated, but monitoring for heart failure and hypotension is crucial.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Unstable angina syndrome poses significant risks to coronary patients.
- Evaluating novel therapeutic strategies is essential for improving patient outcomes.
Observation:
- Verapamil, at 400 mg daily, was administered to 64 patients with unstable angina.
- Patient conditions were assessed using coronarography and the cold test.
- Treatment efficacy was evaluated based on the reduction of anginal attacks.
Findings:
- Over 60% of patients experienced subsided anginal attacks with verapamil, alone or with nitrates.
- Verapamil was ineffective in 24 patients with multi-vessel coronary artery disease refractory to other drugs.
- Myocardial infarction occurred in 11% of patients during hospitalization.
- The cold test showed no predictive value for verapamil efficacy.
- Verapamil was well-tolerated long-term (up to 1.5 years), but requires monitoring for circulatory issues.
Implications:
- Verapamil demonstrates potential as a treatment for unstable angina, particularly in patients responsive to the drug.
- Close patient monitoring is necessary to mitigate risks of heart failure and hypotension.
- Further research may explore patient stratification for optimal verapamil therapy in coronary artery disease.
Abstract:
Verapamil in a 400 mg daily dose was used in 64 coronary patients with the unstable angina syndrome, their condition being assessed by means of coronarography (40) and the cold test (24). Anginal attacks subsided in more than 60% of the patients treated with verapamil alone or in combination with long-acting nitrates, and their treatment was continued on an out-patient basis. In 24 patients, the drug had no effect and was discontinued. Typically, all the three major coronary arteries were affected in these patients, and they were refractory to other antianginal drugs. Myocardial infarction developed during hospital stay in 7 (11%) patients. The cold test has no predictive value with respect to the efficiency of verapamil in these patients, as the rate of positive tests is rather low. The drug taken in a 400 mg dose is easily tolerated by patients over long periods of treatment (up to 1.5 pears), however, their circulatory status should be closely monitored because of a risk of heart failure and arterial hypotension.