Comparative study of gallopamil versus nifedipine in patients with ischemic heart disease
E Molinero De Miguel1, A Salcedo Arruti, J D Sagastagoitia Gorostiza
1Hospital Civil de Basurto, Bilbao, Spain.
Insights
This study found that both gallopamil and nifedipine effectively reduce myocardial ischemia in patients with stable exertional angina. While gallopamil improved stress tolerance, both drugs demonstrated similar overall efficacy in treating ischemic heart conditions.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Stable exertional angina is a common manifestation of coronary artery disease.
- Calcium channel blockers are a cornerstone in managing angina pectoris.
- Gallopamil and nifedipine are calcium antagonists with potential anti-ischemic properties.
Purpose of the Study:
- To compare the anti-ischemic activity of gallopamil and nifedipine in patients with stable exertional angina.
- To evaluate the effects of these drugs on exercise stress test parameters.
- To assess their impact on stress tolerance and myocardial ischemia.
Main Methods:
- A randomized, double-blind, cross-over trial involving 30 male out-patients with proven coronary disease.
- Patients received placebo, gallopamil (150 mg/day), or nifedipine (30 mg/day) for 28-day periods, separated by wash-out phases.
- Efficacy was assessed via physical examination, laboratory tests, and exercise stress tests.
Main Results:
- Both gallopamil and nifedipine significantly reduced maximum ST-segment depression during exercise tests compared to placebo (P < 0.05).
- Gallopamil significantly increased exercise stress tolerance, whereas nifedipine did not show a significant improvement.
- No significant differences in overall efficacy were observed between gallopamil and nifedipine.
Conclusions:
- Both gallopamil and nifedipine are effective calcium antagonists for treating myocardial ischemia in patients with stable exertional angina.
- Gallopamil demonstrated a potential advantage in improving exercise stress tolerance.
- The study suggests comparable therapeutic efficacy between gallopamil and nifedipine for managing ischemic heart conditions.
Abstract:
In order to compare the anti-ischemic activity of gallopamil and nifedipine, a cross-over, double-blind, randomised trial was carried out in 30 male out-patients with a history of stable exertional angina, proven coronary disease and a positive stress test (ST-segment depression > or = 1 mm). After a first 1-week wash-out period on placebo, the patients were randomised to gallopamil, 150 mg/day (50, 50 and 50) or nifedipine, 30 mg/day (10, 10 and 10) for 28 days. After a second 1-week wash-out period active treatments were crossed for another 28 days. At the end of each drug or placebo period, a physical examination, laboratory tests and a stress test were performed. Oral short-acting nitrates were permitted throughout the trial periods. Twenty-one patients finished all periods of the study. Both drugs reduced the maximum ST-segment depression during the exercise test: from 2.45 +/- 0.97 mm (placebo) to 1.95 +/- 0.82 mm (gallopamil, P < 0.05) and from 2.50 +/- 0.93 mm (placebo) to 1.75 +/- 0.84 mm (nifedipine, P < 0.05). Gallopamil but not nifedipine increased stress tolerance significantly: from 486 +/- 156 s (placebo) to 598 +/- 138 s (gallopamil, P < 0.05) and from 509 +/- 113 s (placebo) to 567 +/- 191 s (nifedipine, NS). No significant differences were found between drugs. Both calcium antagonists, gallopamil and nifedipine, showed similar efficacy in treating myocardial ischemia.
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