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Klinische Wochenschrift

, Volume 63, Issue 10, pp 460–467 | Cite as

Die antianginöse Wirksamkeit von Isosorbiddinitrat im akuten Versuch und nach einer 4wöchigen Dauertherapie mit 6 × 40 mg pro Tag

  • W. Schneider
  • A. Wietschoreck
  • W. -D. Bussmann
  • M. Kaltenbach
Originalien
  • 12 Downloads

Abkürzungen

ISDN

Isosorbiddinitrat

IS-2-MN

Isosorbid-2-mononitrat

IS-5-MN

Isosorbid-5-mononitrat

PL

Placebo

Efficiency of isosorbide dinitrate in treating angina pectoris in acute cases and after a four week course of 6×40 mg per day

Summary

Ten patients with angiographically proven coronary heart disease, stable exercise-induced angina pectoris, and reproducible ST-segment depression were treated with isosorbide dinitrate (ISDN) tablets in daily doses of 240 mg (6×40 mg) and placebo (PL) for 28 days each on the basis of a randomized double-blind protocol with intraindividual cross-over. ISDN treatment resulted in a sustained reduction of anginal attacks with a weekly mean rate ranging from 1.4 (3rd week) to 3.9 (4th week) as compared to 10.2 (2nd week) to 11.7 (4th week) during placebo treatment (P<0.001). Ischemic response during stress testing (sum of ST-segment depressions) was significantly improved during ISDN treatment as compared to placebo. Day 1: 56% (P<0.01); day 7: 30% (P<0.01); day 28: 49% (P<0.001). Heart rate and arterial blood pressure in the upright position were different between ISDN and placebo on day 1 and day 7 of the treatment phases (P<0.02), but not on day 28. Nitrate responsiveness with regard to blood pressure and heart rate was restored after a drug-free interval of 2 days. The plasma concentrations for ISDN and the mononitrate metabolites exhibited a constant ratio during the treatment period. Thus, therapy with 6 × 40 mg ISDN per day resulted in a sustained reduction of anginal attacks and preserved improvement of ischemic ST-segment depression during exercise in upright position.

Key words

Isosorbide dinitrate Angina pectoris Sustained therapy Nitrate tolerance Exercise testing 

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Copyright information

© Springer-Verlag 1985

Authors and Affiliations

  • W. Schneider
    • 1
  • A. Wietschoreck
    • 1
  • W. -D. Bussmann
    • 1
  • M. Kaltenbach
    • 1
  1. 1.Zentrum der Inneren MedizinAbteilung für Kardiologie Klinikum der Johann-Wolfgang-Goethe-Universität Frankfurt am MainGermany

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