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      Influence of Isosorbide 5-Mononitrate 20 mg, Sustained-Release 50 mg and Sustained-Release Nifedipine 20 mg on Ischaemic ST-Segment Changes during Holter Monitoring

      Cardiology

      S. Karger AG

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          Abstract

          Objective evidence of transient ischaemia can be obtained by ST-segment analysis of ambulatory ECG recordings. To compare the anti-ischaemic effects of isosorbide 5-mononitrate (IS 5-MN) and nifedipine in sustained-release formulations, we entered 16 patients with documented spontaneous ischaemic episodes in a double-blind cross-over study. The study consisted of four 1-week treatment periods with repeated 24-hour recordings at the end of each period. Nifedipine 3 x 20 mg/day was compared to IS 5-MN 3 x 20 mg/day and IS 5-MN 50 mg once daily for 1 week each. 12 patients completed the study protocol: 1 withdrew because of headache, 1 developed hyperthyroidism and in 2 patients the study was discontinued because the anginal symptoms became unstable.For the entire group both ways of treatment showed beneficial effects with significant reductions of the number of episodes (reduced by 65-68%, p < 0.01), duration of episodes (reduced by 65-70%, p < 0.05) and degree of ST deviation (reduced by 39-70%, p < 0.05). With both IS 5-MN (7 of 12 and 6 of 12 patients) and nifedipine (5 of 12 and 8 of 12) a part of the group of patients became free of ischaemic episodes. In individual patients, however, different patterns of response were observed: 3/12 showed a complete response on both treatments, 1/12 was free on IS 5-MN only and 1/12 on nifedipine only. 6/12 showed a partial response and 1/12 did not respond to either way of treatment.We conclude that (a) IS 5-MN and nifedipine in sustained release are equally effective in treatment of spontaneous ischaemic episodes, and (b) a combination of treatments might be preferable in the majority of such patients.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-4626-3
          978-3-318-01758-8
          0008-6312
          1421-9751
          1987
          1987
          11 November 2008
          : 74
          : Suppl 1
          : 40-45
          Affiliations
          Medizinische Klinik I der Ludwig-Maximilians-Universität, Klinikum Grosshadern, München, FRG
          Article
          174265 Cardiology 1987;74:40–45
          10.1159/000174265
          3300977
          © 1987 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 6
          Categories
          Paper

          General medicine, Neurology, Cardiovascular Medicine, Internal medicine, Nephrology

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