Document Detail


Clinical and hemodynamic evaluation of propranolol in combination with verapamil, nifedipine and diltiazem in exertional angina pectoris: a placebo-controlled, double-blind, randomized, crossover study.
MedLine Citation:
PMID:  3883739     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The clinical and hemodynamic effects of propranolol, propranolol-verapamil (P-V), propranolol-nifedipine (P-N) and propranolol-diltiazem (P-D) were studied in 19 patients with chronic exertional angina pectoris. A placebo-controlled, double-blind, randomized, crossover study design was used in which patients took each treatment for a 4-week period. The 3 combinations equally reduced the incidence of angina attacks and decreased ST-segment depression. Left ventricular hypokinesia during exercise was lessened and end-systolic volume during exercise decreased with all combinations. Because of a corresponding reduction of normokinetic segmental function, global ejection fraction during exercise remained unchanged. Heart size increased (p less than 0.05) and the PR interval lengthened (p less than 0.001) with P-V and P-D compared to P-N. The largest number of adverse clinical reactions occurred with P-V, whereas the fewest occurred with P-D. Almost all patients preferred combined therapy over propranolol and many favored 1 combination over the others. In summary, when therapy with combined beta- and calcium channel-blocking drugs is planned, P-D should be considered the combination of first choice because of its low incidence of adverse clinical effects. In the presence of possible or definite abnormalities of atrioventricular nodal conduction or decreased left ventricular function, P-N should be considered. Although P-V is associated with frequent adverse reactions, a trial may be warranted if the other combinations are unsuccessful.
Authors:
D L Johnston; R Lesoway; D P Humen; W J Kostuk
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  55     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1985 Mar 
Date Detail:
Created Date:  1985-04-19     Completed Date:  1985-04-19     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  680-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angina Pectoris / drug therapy*,  etiology,  physiopathology
Calcium Channel Blockers / therapeutic use*
Clinical Trials as Topic
Diltiazem / therapeutic use
Double-Blind Method
Drug Therapy, Combination / adverse effects
Exercise Test
Female
Hemodynamics / drug effects*
Humans
Male
Middle Aged
Nifedipine / therapeutic use
Placebos
Propranolol / adverse effects,  therapeutic use*
Random Allocation
Verapamil / therapeutic use
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 0/Placebos; 21829-25-4/Nifedipine; 42399-41-7/Diltiazem; 52-53-9/Verapamil; 525-66-6/Propranolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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