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European Heart Journal 1994 15(7):965-970;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Duration and extent of antianginal effects of a sustained-release formulation of nifedipine in angina

M. YOKOTA*,, F. SAITO{dagger}, H. IZAWA{ddagger}, T. MATSUNAMI§, J. YOSHIDA||, H. INAGAKI{ddagger} and I. SOTOBATA

*Department of Clinical Laboratory Medicine, Nagoya University Hospital Nagoya
{dagger}Department of Cardiology, Showa Hospital Kohnan
{ddagger}Department of Cardiology, Toyota Memorial Hospital Toyota
§Department of Cardiology, Saiseikai Hospital Nagoya
||Department of Cardiology, Shinshiro City Hospital Shinshiro
Department of Internal Medicine, Fujita Health University Nanakuri, Mie, Japan

Received 20 August 1993; revised 10 March 1994; .

Correspondence. Mitsuhiro Yokota, MD, PhD, Cardiovascular Section, Department of Clinical Laboratory Medicine, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya, Japan, 466.

Abstract

Twenty-four patients with chronic stable exertional angina pectoris were randomized in a double-blind, placebo-controlled, crossover trial to assess the efficacy and durability of a newly developed, sustained-release formulation of nifedipine (nifedipine CC) in a single 40-mg oral dose. Symptom-limited graded treadmill exercise tests were performed just before, and at 4, 7, and 24 h after a single administration of the drug or the placebo was given. Exercise tolerance at 4, 7, and 24 h after the drug were compared with the corresponding placebo values. Data could be analysed for 19 patients. Maximal exercise time, time to the onset of angina, and time to 1 mm ST segment depression were significantly greater at 4, 7, and 24 h after nifedipine CC than at baseline or with the corresponding placebo. The average maximal exercise time was significantly increased by 72, 76, and 37 s at 4, 7, and 24 h. Rate-pressure product at rest and at peak exercise showed significant changes only at 24 h compared with placebo (both P<0.05). The maximal increase in exercise tolerance was most marked at 7 h after nifedipine CC, at which time plasma drug concentration was 99.4 ± 14. 0 ng. ml–1. Thus, in patients with chronic stable exertional angina pectoris, nifedipine CC showed a prolonged improvement in exercise tolerance up to 24 h after a single oral administration.

Key Words: Effort angina • nifedipine • sustained-release formulation • exercise tolerance • modified Brace's protocol


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