Document Detail

Effect of metoprolol and diltiazem on the total ischaemic burden in patients with chronic stable angina: a randomized controlled trial.
MedLine Citation:
PMID:  8288408     Owner:  NLM     Status:  MEDLINE    
We conducted a randomised controlled trial to study the effects of metoprolol and diltiazem on the total ischaemic burden--sum of symptomatic and silent myocardial ischaemia, in 146 patients with stable angina pectoris. One-hundred thirty-four completed the study protocol. Sixty-eight patients received metoprolol (100 mg twice daily, n = 52, 50 mg twice daily, n = 16) while 66 received diltiazem (90 mg three times daily, n = 50, 60 mg three times daily, n = 16). The drugs were given for 4 weeks. The primary outcome variables were frequency and duration of total ischaemic burden, silent and symptomatic myocardial ischaemia. These were measured on 48 h of Holter monitoring. The reductions in duration and frequency of total ischaemic burden by metoprolol, 76% and 40%, respectively, were significantly higher than by diltiazem, 43% and 24%, respectively (P < 0.01 and P < 0.02). The frequency and duration of silent myocardial ischaemia, which constituted more than 80% of the total ischaemic burden in the two groups showed similar results. However, the reduction in frequency of symptomatic myocardial ischaemia only was significantly greater by metoprolol (63% than diltiazem (24%) as the difference in reduction of duration of symptomatic ischaemia was insignificant (85% vs. 75%; P > 0.05). Whether a greater reduction of total ischaemic burden by metoprolol as compared to diltiazem has any implications for prognosis in patients with chronic stable angina remains to be established.
R C Ahuja; N Sinha; R R Kumar; R K Saran
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of cardiology     Volume:  41     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  1993 Oct 
Date Detail:
Created Date:  1994-02-22     Completed Date:  1994-02-22     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  191-9     Citation Subset:  IM    
Department of Medicine, King George Medical College, Lucknow, India.
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MeSH Terms
Angina Pectoris / drug therapy
Diltiazem / therapeutic use*
Electrocardiography, Ambulatory
Exercise Test
Heart Rate / drug effects
Metoprolol / adverse effects,  therapeutic use*
Middle Aged
Myocardial Ischemia / prevention & control*
Reg. No./Substance:
37350-58-6/Metoprolol; 42399-41-7/Diltiazem

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

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