| Autor: |
Thadani, Udho, Maranda, Claude R., Amsterdam, Ezra, Spaccavento, Leo, Friedman, Richard G., Chernoff, Robert, Zellner, Stephen, Gorwit, Jeffrey, Hinderaker, Paul H., Thadani, U, Maranda, C R, Amsterdam, E, Spaccavento, L, Friedman, R G, Chernoff, R, Zellner, S, Gorwit, J, Hinderaker, P H |
| Předmět: |
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| Zdroj: |
Annals of Internal Medicine; 3/1/94, Vol. 120 Issue 5, p353-359, 7p |
| Abstrakt: |
Objective: To determine whether isosorbide-5-mononitrate (IS-5-MN), an active metabolite of isosorbide dinitrate, when given twice daily (in the morning and 7 hours later), prevents development of tolerance and reduction in exercise performance or is associated with a rebound increase in anginal attacks in patients with stable angina pectoris.Design: Multicenter, placebo-controlled, parallel-group, double-blind, randomized study.Setting: Four university teaching hospitals and five private cardiology outpatient clinics.Patients: 116 patients with stable exertional angina who stopped treadmill exercise because of angina pectoris.Intervention: After stopping all antianginal drugs with the exception of beta-blockers, patients received single-blind placebo for 1 week followed by either 20 mg of IS-5-MN (n = 60 patients) or placebo (n = 62 patients) twice daily at 0800 hours and 1500 hours for 2 weeks.Measurements: Serial symptom-limited exercise tests and patients' diaries recording activity and date, time, and severity of anginal attacks.Results: Compared with placebo recipients, patients receiving IS-5-MN walked significantly longer at 2, 5, and 7 hours after the 0800-hour dose (P < 0.01) and at 2 and 5 hours after the 1500-hour dose (P < 0.01). Before the morning (0800-hour) dose, exercise duration increased by 0.53 minutes in placebo recipients and by 0.85 minutes in those receiving IS-5-MN therapy (P = 0.10). Neither nocturnal nor early-morning anginal attacks increased during IS-5-MN therapy compared with placebo. Headaches occurred in 19 (32%) patients in the IS-5-MN group and in 9 (15%) patients in the placebo group but necessitated discontinuation of treatment in only 2 (3%) patients in the IS-5-MN group.Conclusion: Isosorbide-5-mononitrate, 20 mg twice daily given 7 hours apart, was well tolerated and improved exercise performance for 7 hours after the morning dose and for 5 hours after the afternoon dose without evidence of development of pharmacologic tolerance. No rebound increase in anginal attacks was found. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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