Effect of a combination of pindolol and isosorbide dinitrate on ischemic ST-segment depression and exercise ability...

The antianginal action of a fixed combination of pindolol (7.5 mg) and isosorbide dinitrate (ISDN, 30 mg slow release) was compared with placebo in sixteen patients with stable, exercise-induced angina pectoris. Exercise tests were performed on a bicycle ergometer before and 90 min after the oral application of active drug or placebo. All patients showed an ischemia-induced ST-depression in the ECG during and shortly after exercise. There was no effect of placebo on blood pressure, heart rate, ST-segment depression or work tolerance. The combination of pindolol and ISDN significantly reduced systolic blood pressure and heart rate at rest and during exercise. ST-segment depression was reduced (2 p less than or equal to 0.001), when compared with placebo at the same workload. Mean total work was higher (2 p less than or equal to 0.001) after active drug, leading to an improved exercise-tolerance in 11 out of 16 patients.