Document Detail


Randomized comparison of T-type versus L-type calcium-channel blockade on exercise duration in stable angina: results of the Posicor Reduction of Ischemia During Exercise (PRIDE) trial.
MedLine Citation:
PMID:  12094189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Mibefradil is a T-type calcium-channel antagonist and arterial vasodilator with negative chronotropic effects. It is not known if T-type calcium-channel blockade is superior to L-type calcium-channel blockade in patients with stable angina pectoris. METHODS: A multicenter, randomized, double-blind trial was conducted in patients with documented coronary disease and stable angina to compare a 360 mg dose of diltiazem CD with 100 mg dose of mibefradil. The primary end point was change in time to symptom-limited exercise termination from baseline to 8 weeks. Secondary efficacy parameters included time to onset of persistent ST-segment depression, time to awareness of angina, and change in exercise duration from baseline to 2 and 4 weeks of treatment. RESULTS: A total of 121 patients were randomized to mibefradil and 113 to diltiazem CD. At 8 weeks, the increase in exercise duration was 24.5 seconds greater in the mibefradil group (P =.017; 95% CI 4.4-44.7 seconds). At 8 weeks, time to development of > or =1 mm ST-segment depression was greater by 45.3 seconds (P =.0025; 95% CI 16.2-74.5) with mibefradil, but time to development of angina was not significantly different. CONCLUSION: T-type calcium-channel antagonism with mibefradil improved treadmill exercise parameters compared with diltiazem in patients with chronic stable angina. Further investigation and development of antagonists of T-type calcium channels with fewer adverse drug interactions is warranted and may be promising in the management of ischemic heart disease.
Authors:
Douglas S Lee; Shaun Goodman; Deanne M Dean; Jacques Lenis; Patrick Ma; Pierre B Gervais; Anatoly Langer;
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  144     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2002 Jul 
Date Detail:
Created Date:  2002-07-02     Completed Date:  2002-07-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  60-7     Citation Subset:  AIM; IM    
Affiliation:
St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Angina Pectoris / drug therapy*
Calcium Channel Blockers / therapeutic use*
Calcium Channels, L-Type*
Calcium Channels, T-Type*
Diltiazem / therapeutic use*
Double-Blind Method
Female
Humans
Male
Mibefradil / therapeutic use*
Middle Aged
Myocardial Ischemia / drug therapy
Chemical
Reg. No./Substance:
0/Calcium Channel Blockers; 0/Calcium Channels, L-Type; 0/Calcium Channels, T-Type; 116644-53-2/Mibefradil; 42399-41-7/Diltiazem
Comments/Corrections
Comment In:
Am Heart J. 2003 Jul;146(1):e3   [PMID:  12851630 ]
Am Heart J. 2002 Jul;144(1):8-10   [PMID:  12094182 ]

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


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