Document Detail


Investigation of therapeutic mechanisms of atenolol and diltiazem in patients with variable-threshold angina.
MedLine Citation:
PMID:  8296698     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects of beta-adrenoreceptor and calcium channel-blocking agents on the balance of myocardial oxygen supply and demand were studied in 15 patients (2 women and 13 men), aged 46 to 69 (mean 62) years, with variable-threshold angina. An exercise test was performed before therapy was begun, and 24-hour ambulatory ECG monitoring was performed after 1 week of long-acting nitrate therapy, in the third week after random assignment to either atenolol or diltiazem, and in the third week after crossover. All exercise tests were positive except in one patient taking diltiazem. The exercise time to 0.1 mV ST change was 4.2 +/- 1.7 minutes with no therapy, 5.1 +/- 1.6 minutes with nitrates, 6.6 +/- 0.8 minutes with diltiazem, and 6.5 +/- 2.1 minutes with atenolol. The rate-pressure product at 0.1 mV ST change was 20.9 +/- 4.6 with no therapy and 21.2 +/- 5.7 and 22 +/- 4.6 with nitrates and diltiazem, respectively, but fell to 15 +/- 3.9 beats.min.-1 mm Hg 10(-3) after atenolol (p < 0.01). There was no significant difference in the number of anginal attacks or in nitroglycerin consumption per week. The heart rate at the onset of ST-segment change during the exercise test and during ambulatory ECG monitoring was significantly lower during atenolol than during diltiazem treatment. Both atenolol and diltiazem were of similar efficacy in increasing nonischemic exercise duration in patients with variable-threshold angina and acted primarily by slowing the resting heart rate.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
A Nadazdin; G J Davies
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  American heart journal     Volume:  127     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1994 Feb 
Date Detail:
Created Date:  1994-03-03     Completed Date:  1994-03-03     Revised Date:  2006-02-27    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  312-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Medicine, Royal Postgraduate Medical School, Hammersmith Hospital, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris, Variant / drug therapy*,  physiopathology
Atenolol / therapeutic use*
Blood Pressure / drug effects
Coronary Angiography
Diltiazem / therapeutic use*
Double-Blind Method
Electrocardiography, Ambulatory / drug effects
Exercise Test
Female
Heart Rate / drug effects
Humans
Male
Middle Aged
Myocardial Ischemia / physiopathology,  prevention & control
Nitrates / therapeutic use
Nitroglycerin / therapeutic use
Oxygen Consumption / drug effects
Chemical
Reg. No./Substance:
0/Nitrates; 29122-68-7/Atenolol; 42399-41-7/Diltiazem; 55-63-0/Nitroglycerin

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


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