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[Long-term effect of a new delayed-action nitroglycerin compared to isosorbide dinitrate. Double-blind hemodynamic
Deutsche Medizinische Wochenschrift (1946)
|February 11, 1983
Summary
Cellulose-bound nitroglycerin (Nitroglin) offers oral long-term nitrate therapy for coronary heart disease. While effective, high doses may reduce cardiac output, requiring careful patient selection.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Coronary heart disease management often involves long-term nitrate therapy.
- Oral nitrate formulations aim to provide sustained hemodynamic effects.
Purpose of the Study:
- To evaluate the oral long-term effects of cellulose-bound nitroglycerin (Nitroglin) in patients with coronary heart disease.
- To compare Nitroglin's efficacy and duration of action with sustained-release isosorbide dinitrate and placebo.
Main Methods:
- A randomized, double-blind protocol was used to assess hemodynamic parameters.
- Patients received oral Nitroglin (10 mg and 20 mg), isosorbide dinitrate (40 mg sustained release), or placebo.
Main Results:
- All active treatments demonstrated comparable maximal effects on right heart pressures within 1-4 hours.
- Cellulose-bound nitroglycerin showed sustained action up to 6 hours (10 mg) and 8 hours (20 mg).
- The 20 mg Nitroglin dose was equipotent to 40 mg sustained-release isosorbide dinitrate, but associated with potential 30-40% cardiac output reduction.
Conclusions:
- Cellulose-bound nitroglycerin is a viable oral long-term nitrate therapy for coronary heart disease.
- The 20 mg dose, while effective, necessitates caution due to potential adverse hemodynamic effects.