| The angiographic and clinical benefits of mibefradil in the coronary slow flow phenomenon. | |
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MedLine Citation:
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PMID: 15234407 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: The aim of the study was to assess the angiographic and clinical benefits of the calcium T-channel blocker, mibefradil, in the coronary slow flow phenomenon (CSFP). BACKGROUND: The CSFP is characterized by delayed vessel opacification on angiography (Thrombolysis In Myocardial Infarction [TIMI]-2 flow) in the absence of obstructive epicardial coronary disease and is often associated with recurrent chest pain. METHODS: A total of 10 CSFP patients (46 +/- 9 years) underwent angiography before and 30 min after 50 mg mibefradil; off-line blinded analysis of angiographic data included comparisons of epicardial vessel diameter, TIMI flow grade and TIMI frame count. We also performed a randomized, double-blind, placebo-controlled, cross-over study to examine the long-term efficacy of mibefradil 100 mg/day on the frequency of total angina, prolonged angina (i.e., persisting >20 min) episodes, and sublingual nitrate consumption, during consecutive one-month treatment periods in 20 patients (age 51 +/- 12 years) with the CSFP. RESULTS: Without changing epicardial vessel diameter or rate-pressure product, mibefradil reduced the number of vessels exhibiting TIMI-2 flow from 18 to 5; furthermore, mibefradil significantly improved the TIMI frame count only in those vessels exhibiting TIMI-2 flow (28 +/- 18%, p < 0.005). Compared with placebo, mibefradil significantly reduced total angina frequency by 56% (p < 0.001), prolonged episodes of angina by 74% (p < 0.001), and sublingual nitrate consumption by 59% (p < 0.01); furthermore, mibefradil improved physical quality of life as assessed by the Health Outcome Study Short Form-36. CONCLUSIONS: These angiographic and clinical improvements produced by mibefradil support a microspastic pathogenesis of the CSFP. |
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Authors:
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John F Beltrame; Stuart P Turner; Sue L Leslie; Patty Solomon; Saul B Freedman; John D Horowitz |
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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: Journal of the American College of Cardiology Volume: 44 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2004 Jul |
Date Detail:
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Created Date: 2004-07-05 Completed Date: 2004-09-23 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 57-62 Citation Subset: AIM; IM |
Affiliation:
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Cardiology Unit, North Western Adelaide Health Service, University of Adelaide, Adelaide, Australia. john.beltrame@adelaide.edu.au |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Biological Markers / blood Blood Flow Velocity / drug effects* Blood Pressure / drug effects C-Reactive Protein / metabolism Calcium Channel Blockers / administration & dosage, therapeutic use* Coronary Angiography* Coronary Disease / diagnosis, drug therapy*, physiopathology* Coronary Vessels / physiopathology, ultrasonography Cross-Over Studies Diastole / drug effects Dose-Response Relationship, Drug Double-Blind Method Echocardiography Electrocardiography, Ambulatory Female Heart Conduction System / drug effects, metabolism, physiopathology Heart Rate / drug effects Humans Male Mibefradil / administration & dosage, therapeutic use* Middle Aged Patient Compliance Statistics as Topic Systole / drug effects Treatment Outcome Troponin I / blood |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 0/Calcium Channel Blockers; 0/Troponin I; 116644-53-2/Mibefradil; 9007-41-4/C-Reactive Protein |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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