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      Slow Release Isosorbide-5-Mononitrate Therapy in Angina Pectoris

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          Abstract

          The possibility of maintaining preload reduction and enhancement of exercise tolerance during an interval treatment with 100 mg/day of slow-release isosorbide-5-mononitrate (IS-5-MN) was investigated in 12 patients (aged 57 ± 5.0 years) with angiographically confirmed coronary artery disease and chronic stable angina pectoris. The effects of a single dose (acute test) were compared with those following an 8-day (chronic) regimen of mononitrate administration. Two hours after administration of 100 mg sustained-release IS-5-MN, mean resting pulmonary artery pressure (PAP), measured with a Swan-Ganz catheter, was reduced by 32% (p < 0.001) and at submaximal exercise level (50 W, 3 min) by 37% (p < 0.001). At individually highest comparable work loads mean PAP was reduced by 37% (p < 0.001), and at maximal work load the PAP reduction was 14% (p < 0.05). At the end of 1 week of therapy with sustained-release IS-5-MN a slight, clinically irrelevant reduction of hemodynamic effects was recorded. Work capacity increased after 1 h by 79% (264 ± 154 vs. 472 ± 180 W × min, p < 0.01), still significantly above base-line 10 h after nitrate administration. No difference from baseline was demonstrable 24 h after medication. During interval therapy the improved work capacity was fully maintained (chronic, 1 h: 280 ± 119 vs. 532 ± 160 W × min, p < 0.001). There was no significant difference between the plasma IS-5-MN levels at acute and chronic therapy. During interval therapy with sustained-release IS-5-MN, hemodynamics and exercise tolerance were durably improved. Thus, the once-daily intake is beneficial for patient compliance and prevents tolerance development during long-term therapy of coronary artery disease.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-5486-2
          978-3-318-01618-5
          0008-6312
          1421-9751
          1991
          1991
          12 November 2008
          : 79
          : Suppl 2
          : 78-85
          Affiliations
          Medizinische Klinik I, Städtisches Krankenhaus, Leverkusen, FRG
          Article
          174929 Cardiology 1991;79:78–85
          10.1159/000174929
          1760835
          © 1991 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.

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          Pages: 8
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