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European Heart Journal 1993 14(3):416-420;
Copyright © 1993 by the European Society of Cardiology.
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© 1993 The European Society of Cardiology

Acute effects of nifedipine, diltiazem and their combination in patients with chronic stable angina: a double-blind, randomized, cross-over, placebo-controlled study

L. DE CAPRIO, D. ACANFORA*, L. ODIERNA*, A. DI PALMA, C. ROMANIELLO, C. RENGO, A. GIORDANO and F. RENGO

Instituto di Medicina Interna, Cardiologia e Chirurgia Cardiovascolare, Cattedra die Geriatria, II Facoltá di Medicina e Chirurgia, Universitá degli Studi di Napoli Italy
*Fondazione Clinica Del Lavoro, Centro Medico Di Campoli M. T. (Benevento), I.R.C.C.S. Italy

Received 9 January 1992; revised 10 July 1992; .

Correspondence: Dr Lorenzo De Caprio, Via Bologna I, Puccianiello (Cacerto), CAP 81020, Italy

Abstract

We evaluated the acute therapeutic effects of the oral administration of n (10mg) and diltiazem (120 mg) alone and in combination in 16 patients with effort angina. The 16 patients (13 men and three women; mean age 59±7 years) performed a symptom-limited bicycle exercise stress test 3 h after placebo or active substance administration. Maximal work load, exercise duration and time to 1 mm ST segment depression were significantly increased and ST depression at peak exercise was significantly decreased by the combination of drugs. N and diltiazem alone similarly improved exercise duration as markedly as their combination. One patient stopped the test after all three treatments for angina associated with ST depression > 2mm. The combination of drugs yielded the best symptomatic effect: only four patients complained of angina in comparison to eight and seven patients after diltiazem and n respectively.

Nifedipine and diltiazem are effective and safe antianginal drugs. Some patients respond better to one drug than to the other. Patients who remain symptomatic in spite of maximal doses of a single drug may derive some benefit from combination therapy.

Key Words: Nifedipine • diltiazem • coronary artery disease • exercise stress test


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