The antianginal and anti-ischemic efficacy of isosorbide dinitrate (ISDN) retard 120, verapamil 120 sustained-release (s.r.) and their combination was evaluated in 30 patients with chronic angina pectoris. The study was a randomized, double-blind crossover comparison. The evaluation was determined by exercise testing and 24-hour electrocardiographic ambulatory monitoring. The sum of ...

The acute effects on exercise tolerance and electrocardiographic ischaemia of felodipine and diltiazem, alone or in combination, were investigated in 12 patients with documented stable effort-induced angina pectoris. After being withdrawn from their previous antianginal treatments, patients received a single oral dose of felodipine 10 mg, diltiazem 60 mg, their ...

A placebo-controlled, double-blind, dose-response study of amlodipine (1.25, 2.5, 5, and 10 mg once daily) was carried out in 136 patients with stable exertional angina pectoris. Improvements in total exercise tolerance, time to onset of angina during exercise, ST-segment deviation at maximum common load, frequency of angina attacks, and nitroglycerin ...

An investigation on the therapeutic effect of L-carnitine was performed at three different centres and included two hundred patients, 40 to 65 years of age, with exercise-induced stable angina. In one hundred randomly selected patients the drug was administered orally in daily doses of 2 g in addition to the ...

Episodes of transient myocardial ischemia during ambulatory activities are common in patients with stable coronary artery disease and who are often asymptomatic. Selection of therapy for episodes of asymptomatic ischemia is limited by a lack of direct comparative studies. To determine the most effective monotherapy for patients with stable angina ...

The predictive value of several exercise test parameters in identifying stable angina patients at risk of silent myocardial ischemia during daily life were examined. A total of 97 patients with coronary artery disease, stable angina and ambulatory electrocardiographic data were evaluated. Of the 86 patients with a positive exercise test, ...

The effects of theophylline (400 mg twice a day), atenolol (50 mg twice a day) and their combination on myocardial ischemia were studied in 9 patients with stable angina pectoris in a randomized, single-blind, triple crossover trial. Placebo was administered to the patients during the run-in and the run-off periods. ...

In a double-blind 16-week crossover study, the effectiveness of verapamil therapy for chronic stable angina was evaluated in 19 patients (Phase I). Twelve of these patients were then followed for 38 to 58 months of open-label treatment (Phase II). Clinical responses were assessed with traditional indices, treadmill exercise tests, and ...

The efficacy of benazepril, metoprolol OROS and their combination was evaluated in 29 patients (42 to 74 years of age) with chronic stable angina and documented coronary artery disease in a placebo-controlled, double-blind, crossover trial using serial quantitated exercise testing and ambulatory electrocardiographic (ECG) monitoring. The mean (+/- SEM) exercise ...

The 24-hour application of transdermal nitrate patches has been associated with rapid development of therapeutic tolerance. Recent reports suggest maintenance of clinical benefit by introducing a daily patch-free period. This study investigates, by means of serial treadmill testing, the efficacy of a new transdermal delivery system when used with an ...

In recent years, concern has been expressed over attenuation of therapeutic effect in patients receiving continuous nitroglycerin therapy for the treatment of angina. Studies have shown that exercise tolerance time does not improve with continuous nitroglycerin regimens, although the frequency of anginal attacks may decrease. Intermittent therapy, which incorporates a ...

The effects of nifedipine on left ventricular function were evaluated in 17 patients with coronary artery disease with an ambulatory radionuclide detector (VEST). Hemodynamic data were recorded continuously at rest and during upright bicycle ergometer exercise before and 30 minutes after 10 mg of oral nifedipine administration. The heart rate ...

We studied the short-term effects of oral administration of nisoldipine (10 mg) and propranolol (80 mg) alone and in combination in 14 patients with chronic exertional angina pectoris in a double-blind, randomized, cross-over study. The 14 patients (13 men and 1 woman, mean age 56 +/- 7 years) performed symptoms-limited ...

A randomized, double-blind, placebo-controlled study was performed to investigate the effect of dipyridamole at a usual oral dose of 150 mg/day on 18 patients with angina pectoris and positive treadmill exercise electrocardiography. After their angina pectoris was stabilized in phase 1, the patients were randomly assigned to sequence group A ...

Trimetazidine has been shown to have an antianginal effect, increasing exercise capability without producing any significant change of heart rate or systolic blood pressure. The aim of this study was to compare trimetazidine efficiency to that of another classical antianginal drug. A double-blind crossover trimetazidine versus nifedipine trial was carried ...

Coronary vasoconstriction may play a relevant role in the pathogenesis of exercise-induced myocardial ischemia, not only in patients with Prinzmetal's angina, but also in patients with chronic stable angina. In these patients the use of calcium antagonists, namely, dihydropyridine derivatives, may be beneficial. Hyperventilation is a simple and sensitive test ...

Since not all patients tolerate beta-blockers, the efficacy of nifedipine and isosorbide dinitrate was evaluated alone and in combination in patients with stable angina pectoris. The study was a randomized double-blind crossover design with patients titrated to maximally tolerated doses of both drugs. Phases included isosorbide dinitrate alone, nifedipine alone, ...

The acute effects of slow-release nifedipine and isosorbide dinitrate on exercise tolerance were compared in nine patients with isolated total coronary artery occlusion showing retrograde filling via collaterals. All patients had a reproducible positive exercise stress test off medication before the study. Each patient was randomized to 10 mg slow-release ...

Since many patients with a wide variety of diseases are nowadays stimulated to adopt a physically active lifestyle, the question of the influence of exercise on the pharmacokinetics of drugs has become more and more relevant. Because exercise influences a large number of physiological factors that also determine the pharmacokinetics ...

The effects of two calcium channel blockers, diltiazem (270 mg/day) and verapamil (240 mg/day), were studied in 18 patients with chronic atrial fibrillation. During 24 h Holter electrocardiographic monitoring, mean ventricular rate (beats/min) decreased from 88 +/- 14 with placebo to 76 +/- 13 (p less than 0.001) with diltiazem ...

Exercise treadmill tests and ambulatory monitoring were used in a double-blind, placebo-controlled, double-dummy crossover comparison of nifedipine (10 mg, 3 times daily) and transdermal nitroglycerin (15 mg). All patients (n = 20) had chronic stable angina with symptomatic and silent events. All patients had 3 episodes of angina/week and 3 ...

The magnitude and duration of the antianginal and anti-ischemic effects of isosorbide mononitrate (IS-5-MN), 20 mg, were determined in 10 patients with chronic stable angina pectoris. An exercise test (treadmill, Bruce protocol) was performed before and at 1, 6, 8 and 10 hours after oral administration of the drug. The ...

The possibility of maintaining preload reduction and enhancement of exercise tolerance during an interval treatment with 50 mg/day of sustained-release isosorbide-5-nitrate (IS-5-N) was investigated in 13 patients (aged 54.4 +/- 7.9 years [mean +/- standard deviation]) with angiographically confirmed coronary artery disease and chronic stable angina pectoris. The effects of ...

Thirty-three men with stable exercise-induced angina pectoris entered a randomized, double-blind, crossover study in which controlled-release isosorbide-5-mononitrate 60 mg once daily was compared with conventional isosorbide dinitrate 20 mg 3 times daily. Each drug was given for 2 weeks. Twenty-eight patients completed the study and data on exercise variables are ...

To investigate the mechanism of antianginal action of the calcium channel blocker nisoldipine and to determine the reproducibility of the clinical and hemodynamic events induced by supine leg exercise, 30 patients with stable effort angina pectoris were studied. They were divided into two groups; one group of 19 patients received ...

Eighteen male patients (aged 40-66 years) with confirmed ischaemic heart disease and a minimum of four angina attacks per week were included in a double-blind comparison of dilevalol 200 mg, dilevalol 400 mg and atenolol 100 mg. Following a one-week placebo run-in period patients were randomly allocated to one of ...

In a randomized double-blind study, the haemodynamic and anti-ischaemic effects of the new dihydropyridine calcium channel blocker isradipine (5 mg and 10 mg thrice daily (t.i.d.) were investigated over 1 week in nine patients with coronary artery disease and chronic effort angina and compared with nifedipine (20 mg t.i.d.) and ...

Nifedipine may be effective in the treatment of stable angina by both decreasing myocardial oxygen demand and increasing myocardial oxygen supply. To determine the mechanism of action of nifedipine and its dose-response relation, 14 patients with stable angina were treated with nifedipine 10, 20 and 30 mg 4 times daily ...

The purpose of this study was to investigate the symptomatic and physiologic responses during moderate to heavy resistance exercise in a population with coronary artery disease. After at least 12 weeks of aerobic training without experiencing complications, 15 male cardiac patients were selected for the study. Approximately one week after ...

A prospective, randomized study compared the effects of equivalent intravenous doses of three slow calcium-channel blockers (verapamil, diltiazem, and amlodipine) on rest and exercise haemodynamics in 30 ischemic heart disease patients. Following a stable control period during which rest and exercise (supine bicycle) hemodynamics were assessed, equivalent hypotensive doses of ...

Two-hundred-and-eighty individuals with anginal complaints, without prior myocardial infarction and with a positive exercise stress test were divided into a group (n = 67) with exercise-induced silent myocardial ischemia and another group (n = 213) with exercise-induced angina pectoris. Both underwent coronary angiography and were compared with each other with ...

Treatment with nisoldipine (2 x 10 mg tablets once daily) and nifedipine (2 x 10 mg capsules three times daily) in patients with severe, but stable effort angina pretreated with atenolol (100 mg once daily in 19 patients and 50 mg once daily in one patient) were compared for their ...

Betaxolol is a new, highly cardioselective, once-a-day beta blocker with a long half-life (mean 16 hours). The antianginal efficacy of 2 doses of betaxolol (20 and 40 mg) given once daily was evaluated and compared with propranolol (40 or 80 mg) 4 times daily. Ninety-two patients completed the 10-week double-blind ...

The variable 'walking time to moderate angina' on an exercise stress test is the primary means to judge the efficacy of new treatments for angina pectoris. Unfortunately, 'walking time to moderate angina' is often censored by fatigue or other reasons for premature termination of the exercise stress test. If time ...

This study was performed to examine whether cilazapril, a novel nonsulfhydril angiotensin-converting enzyme (ACE) inhibitor, may improve regional myocardial perfusion at exercise in patients with coronary heart disease (CHD). In a single-blind, nonrandomized trial, 5 mg cilazapril or placebo was administered to eight patients with documented CHD and stable exertional ...

To assess the anti-anginal and anti-ischaemic efficacy of the ACE-inhibitor enalapril in normotensive coronary patients, a double-blind, cross-over, placebo-controlled study was performed. Eight male patients, aged 45-68 years, with stable effort angina were given enalapril (10 mg) once a day or placebo for 7 days. Maximal exercise stress tests 10w/min ...

In order to evaluate the effects of acupuncture in moderate, stable angina pectoris, 49 patients were randomized to either genuine or sham acupuncture. In sham acupuncture needles were inserted into points within the same spinal segment as in genuine acupuncture, but outside the Chinese meridian system. The effect was evaluated ...

The short-term effects of oral diltiazem on hemodynamics and distribution of cardiac output at rest and during semiupright bicycle exercise were evaluated in eight patients with stable effort angina on long-term beta 1-adrenergic blockade. Cardiac output and iliofemoral blood flow were measured using thermodilution. The patients were exercised to the ...

The effect of a controlled-release formulation of isosorbide-5-mononitrate (IS-5-MN) was studied in patients with coronary heart disease (CHD), with the aim of comparing the acute effect with that after chronic administration on parameters of ischemia. To determine whether any tolerance developed, several aspects of ischemia were observed: ECG signs, clinical ...

The cardiovascular effects of single oral doses of nifedipine (5 and 10 mg) and nicardipine (20 and 30 mg) were compared in a placebo controlled double-blind crossover study involving 8 healthy male volunteers. Two hours following drug administration stroke volume and cardiac index were measured non-invasively using transthoracic electrical bioimpedance ...

Ranolazine (RS-43285) has been shown to possess significant anti-ischaemic properties in a canine model of reversible myocardial ischaemia. The clinical efficacy of this new agent was assessed by a single blind, placebo controlled study of 14 patients with chronic stable angina. A 2 week placebo phase was followed by therapy ...

In stable exercise-induced angina pectoris, beta-blockers exert their beneficial effects mainly through a reduction in heart rate, blood pressure. and contractility. Additional beneficial effects are an improvement in myocardial oxygen supply through a redistribution of coronary flow, a lengthening of diastole, a facilitation of aerobic metabolism, and a rightward shift ...

The different mechanisms of action of beta-blockers and calcium antagonists could result in an additive therapeutic effect in patients with angina pectoris. Twenty-one male patients aged between 41 and 68 years and suffering from chronic stable angina pectoris and coronary artery disease confirmed by angiography took part in a randomized, ...

The organic nitrates are effective agents in the management of patients with angina pectoris. They are the agents of choice in the treatment of acute episodes of angina pectoris and are useful in angina prophylaxis. While the organic nitrates are extremely effective in angina prophylaxis during acute therapy, there is ...

To determine the value of a 6-month exercise treadmill test for detecting restenosis after elective percutaneous transluminal coronary angioplasty (PTCA), 303 consecutive patients with successful PTCA and without a recent myocardial infarction were studied. Among the 228 patients without interval cardiac events, early repeat revascularization or contraindications to treadmill testing, ...

Sustained-release diltiazem, 120 and 180 mg twice daily, was assessed in a multicenter, double-blind, randomized, placebo-controlled trial in 65 stable angina patients with exercise-induced ST depression. Exercise testing was performed 12 +/- 1 hours after the last dose at the end of each of the 3 treatment weeks. Both dose ...

To examine the chronic effects of nicorandil, a new coronary vasodilator, on exercise tolerance, we gave this drug for ten days at 15 mg/day orally in three divided doses to 10 patients with stable effort angina. An increase in exercise capacity by more than 1 stage of modified Bruce's protocol ...

The purpose of the present study was to determine the value of exercise testing (ET) and dipyridamole echocardiography test (DET) in the early functional evaluation after a successful coronary angioplasty (PTCA) and in the prediction of angina recurrence. 52 patients underwent ET and DET before and 48 h after a ...

While the role of nitrates in the prevention and treatment of myocardial ischemia is well established, the use of theophylline, proposed almost a century ago, is still controversial. Also controversial is its mechanism of action, initially thought to be coronary dilation. In this randomized, single-blind study, the acute effects on ...

The present study evaluates the effect of the beta 1 partial agonist xamoterol in patients with coronary artery disease compared to the effect in patients with dilated cardiomyopathy. Nineteen patients with angina pectoris and nine patients with dilated cardiomyopathy received xamoterol 200 mg b.i.d. for 4 weeks in a placebo-controlled ...