» Articles » PMID: 3925217

[Anti-angina Effectiveness of Isosorbide Dinitrate in an Acute Trial and Following Continuous 4-week Therapy with 40 Mg 6 Times a Day]

Overview
Journal Klin Wochenschr
Specialty General Medicine
Date 1985 May 15
PMID 3925217
Citations 1
Authors
Affiliations
Soon will be listed here.
Abstract

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 X 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 less than 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 less than 0.01); day 7: 30% (P less than 0.01); day 28: 49% (P less than 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 less than 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 X 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.

Citing Articles

Nitrate tolerance. A review of the evidence.

Flaherty J Drugs. 1989; 37(4):523-50.

PMID: 2661197 DOI: 10.2165/00003495-198937040-00006.

References
1.
Silber S, Krause K, Garner C, Theisen K, JAHRMARKER H . Anti-ischemic effects of an 80-mg tablet of isosorbide dinitrate in sustained-release form before and after 2 weeks treatment with 80 mg once daily or twice daily. Z Kardiol. 1983; 72 Suppl 3:211-7. View

2.
Franciosa J, Leddy C, Schwartz D . Importance of venodilation during long-term vasodilator therapy of chronic left ventricular failure. Z Kardiol. 1983; 72 Suppl 3:168-72. View

3.
Leier C, Huss P, Magorien R, Unverferth D . Improved exercise capacity and differing arterial and venous tolerance during chronic isosorbide dinitrate therapy for congestive heart failure. Circulation. 1983; 67(4):817-22. DOI: 10.1161/01.cir.67.4.817. View

4.
Tauchert M, Jansen W, Osterspey A, Fuchs M, Hombach V, Hilger H . Dose dependence of tolerance during treatment with mononitrates. Z Kardiol. 1983; 72 Suppl 3:218-28. View

5.
NEEDLEMAN P, Johnson Jr E . Mechanism of tolerance development to organic nitrates. J Pharmacol Exp Ther. 1973; 184(3):709-15. View