| Abrupt cessation of short-term continuous treatment with isosorbide dinitrate may cause a rebound increase in silent myocardial ischaemia in patients with stable angina pectoris. | |
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MedLine Citation:
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PMID: 8665335 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To examine by Holter electrocardiographic monitoring the effect of abruptly stopping nitrate treatment in patients with stable angina pectoris. PATIENTS: 12 men with confirmed ischaemic heart disease and stable exertional class 3 angina (Canadian). All had episodes of horizontal or down sloping ST segment depression during 24 hour electrocardiographic monitoring. All were nitrate responders. DESIGN: Each patient was given isosorbide dinitrate (10-30 mg four times a day) and placebo (four times a day) for three days in a randomised crossover trial. There was a washout period of 3-5 days between the two treatment periods. Holter monitoring was performed on the third day of isosorbide dinitrate and placebo administration and on the first day of their withdrawal. RESULTS: When treatment with isosorbide dinitrate was stopped there was a significant increase in the total number and duration of painless episodes of myocardial ischaemia. During placebo and isosorbide dinitrate administration 8 patients had episodes of painless myocardial ischaemia whereas after isosorbide dinitrate cessation they were recorded in all 12 patients. Episodes of silent myocardial ischaemia at rest appeared in 4 patients after isosorbide dinitrate withdrawal. CONCLUSION: Abrupt cessation of short-term continuous nitrate treatment in patients with severe angina may cause a rebound increase in myocardial ischaemia which is predominantly silent. |
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Authors:
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S Y Martsevich; N Koutishenko; V I Metelitsa |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Heart (British Cardiac Society) Volume: 75 ISSN: 1355-6037 ISO Abbreviation: Heart Publication Date: 1996 May |
Date Detail:
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Created Date: 1996-08-08 Completed Date: 1996-08-08 Revised Date: 2009-11-18 |
Medline Journal Info:
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Nlm Unique ID: 9602087 Medline TA: Heart Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 447-50 Citation Subset: AIM; IM |
Affiliation:
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Department of Preventive Pharmacology, Research Centre for Preventive Medicine of Russia, Moscow. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angina Pectoris / drug therapy*, physiopathology Cross-Over Studies Drug Administration Schedule Electrocardiography, Ambulatory Exercise Tolerance / drug effects Humans Isosorbide Dinitrate / adverse effects* Male Middle Aged Myocardial Ischemia / chemically induced*, diagnosis Substance Withdrawal Syndrome* Vasodilator Agents / adverse effects* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 87-33-2/Isosorbide Dinitrate |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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