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European Heart Journal 1996 17(Supplement G):64-68; doi:10.1093/eurheartj/17.suppl_G.64
Copyright © 1996 by the European Society of Cardiology.
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© 1996 1996 The European Society of Cardiology

Treatment effects on the total ischaemic burden and prognostic implications

J. Deanfield

Great Ormond Street Hospital for Children and St. Bartholomew's Hospital London, U.K.

Correspondence: Dr John E. Deanfield, Cardiothoracic Unit, Great Ormond Street Hospital, London, WC1N 3JH, U.K.

Anginal symptoms alone are not a reliable guide to the extent of patients’ ischaemic heart disease and silent episodes of ischaemia are associated with increased morbidity and mortality. It is becoming apparent that effective treatment of ischaemia will have to target the pattern of ischaemic events seen in patients’ daily lives and treatment strategies are now being developed which aim to eliminate both silent and symptomatic episodes of ischaemia over the whole 24-h period. For example, the Circadian Anti-ischemia Program in Europe (CAPE) trial has shown that significant improvements in objective and subjective measures of ischaemia occurred over 24 h when the once daily, third-generation dihydropyridine calcium antagonist amlodipine was added to background medical therapy. In addition, the Canadian Amlodipine/Atenolol in Silent Ischemia Study (CASIS) has clearly shown the complementary effects of combination therapy with amlodipine and the long-acting β-blocker atenolol. Ongoing and future outcome studies will determine the impact of such approaches on the prognosis for patients with ischaemic heart disease. (Eur Heart J 1996; 17 (Suppl G): 64–68)

Key Words: Amlodipine • ischaemic heart disease • continuous ambulatory ECG monitoring


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