Intravenous diltiazem versus nitroglycerin for silent and symptomatic myocardial ischemia in unstable angina pectoris
| Autor: | Philippe Unger, Rudy Scheldewaert, Zhen Ying Fang, Guy Berkenboom, Nelly Picart, Marc Abramowicz, Serge Degré, John Sobolski, Pascale Narracci |
|---|---|
| Rok vydání: | 1991 |
| Předmět: |
Male
medicine.medical_specialty Ischemia Coronary Artery Disease Coronary Angiography Asymptomatic Coronary artery disease Angina Diltiazem Nitroglycerin Heart Rate Internal medicine Heart rate medicine Humans Single-Blind Method Angina Unstable cardiovascular diseases Ergonovine Aged business.industry Unstable angina Middle Aged medicine.disease Anesthesia Electrocardiography Ambulatory cardiovascular system Coronary care unit Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business circulatory and respiratory physiology medicine.drug |
| Zdroj: | The American Journal of Cardiology. 68:42-46 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/0002-9149(91)90222-7 |
| Popis: | For 18 patients consecutively admitted to the coronary care unit for unstable angina, 48-hour electrocardiographic Holter monitoring was performed after they were randomly assigned in a single-blind fashion to 1 of 2 treatment groups. The first group was treated with acetylsalicylic acid (ASA) and intravenous nitroglycerin, the second with ASA and intravenous diltiazem. All of the patients treated with nitroglycerin still had ischemic episodes after 48 hours (33% were symptomatic), in contrast with 11% of the diltiazem group (11% asymptomatic). Maximal ST-segment depressions of symptomatic and asymptomatic episodes were significantly different; and no significant increases in heart rate were observed either during the 15 seconds before ischemia began or during the ischemic episode. During the 48 hours, the diltiazem group had significantly fewer ischemic episodes (17) than did the nitroglycerin group (145). We concluded that "on-line" ST-segment observation is of prime importance for monitoring unstable angina; that the majority of the ischemic episodes associated with unstable angina are silent; and that intravenous diltiazem could be an effective pretreatment for patients who must undergo mechanical or surgical therapy. |
| Databáze: | OpenAIRE |
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