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Anipamil prevents ST depression in patients with stable angina pectoris
C T Larsen1, C Sørum, V Rasmussen
1Department of Cardiology, Hvidovre University Hospital, Copenhagen, Denmark.
Insights
Once-daily anipamil effectively treats stable angina by significantly reducing myocardial ischemia. This anti-ischemic drug demonstrates 24-hour efficacy, making it a valuable option for patients with transient myocardial ischemia.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Stable angina pectoris is a common condition characterized by chest pain due to myocardial ischemia.
- Current treatments aim to reduce the frequency and severity of ischemic episodes.
Purpose of the Study:
- To evaluate the 24-hour anti-ischemic efficacy of once-daily anipamil in patients with stable angina.
- To compare the effects of anipamil 80 mg and 160 mg against placebo.
Main Methods:
- Double-blind, placebo-controlled crossover study design.
- Inclusion of 19 patients with stable angina and documented ischemia.
- 24-hour ambulatory ECG monitoring to assess transient myocardial ischemia duration.
Main Results:
- Anipamil significantly reduced the total duration of transient myocardial ischemia.
- Anipamil 80 mg reduced ischemia duration to 712 minutes (p < 0.001), with 87% asymptomatic episodes.
- Anipamil 160 mg reduced ischemia duration to 913 minutes (p > 0.001), with 92% asymptomatic episodes.
Conclusions:
- Once-daily anipamil is an effective 24-hour anti-ischemic treatment for stable angina.
- Anipamil demonstrates significant efficacy in reducing both symptomatic and asymptomatic transient myocardial ischemia.
Abstract:
The purpose of this study was to examine the 24-hour antiischemic efficacy of once-a-day anipamil compared to placebo in the treatment of patients with stable angina. The study was designed as a double-blind, placebo-controlled crossover study with an initial 3 week single-blind placebo period. The patients received anipamil 80 mg once daily, anipamil 160 mg once daily, and placebo in a randomized order. At the end of each treatment period the patients underwent 24-hour ambulatory ECG recording. Nineteen patients were included, all with typical stable angina pectoris for at least 2 months, exercise test with > or = 0.10 mV horizontal or down-sloping ST-segment depression and limited by angina pectoris, and at least 10 attacks of angina pectoris in the initial single-blind placebo period. During the placebo period, a total duration of transient myocardial ischemia > or = 0.10 mV during the 24-hour ambulatory ECG monitoring period was 2263 minutes, 75% of which were asymptomatic. Anipamil 80 mg and 160 mg significantly reduced the duration of episodes to 712 minutes (p < 0.001), with 87% asymptomatic, and to 913 minutes (p > 0.001), with 92% asymptomatic, respectively. In conclusion, anipamil given once a day is an effective 24-hour antiischemic drug in the treatment of transient myocardial ischemia.