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      Evaluation of the Antianginal and Anti-Ischemic Efficacy of Slow-Release Isosorbide-5-Mononitrate Capsules, Bupranolol and Their Combination, in Patients with Chronic Stable Angina Pectoris

      Cardiology

      S. Karger AG

      Mononitrate, Angina pectoris

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          Abstract

          The effects of slow-release isosorbide-5-mononitrate (IS-5-MN), 25 mg once daily, bupranolol, 50 mg once daily, and their combination on exercise-induced ST-segment depression at comparable work load, maximal work load, exercise capacity, frequency of anginal episodes and sublingual nitroglycerin consumption were studied in 30 patients with chronic stable angina pectoris. The patients were assigned in a randomized, double blind protocol, to either form of monotherapy, for 12 days, and thereafter to combined therapy for 12 days. Exercise stress test was performed before treatment and at 2 and 16 h after drug administration on the first and 12th day of each treatment period. ST-depression at comparative work load at 2 h after dosing was reduced by 49% acutely after administration of IS-5-MN. This effect was not significantly altered after 12 days of treatment and during combined therapy. In those patients treated by bupranolol alone, an effect was observed only after 12 days – a 24% reduction in ST depression. At the 12th day of combined therapy ST-segment depression was reduced by 65%. At 16 h after dosing there was no significant reduction in mean values of ST-segment depression in either groups, but some patients in each group showed a sustained effect for 16 h. Both drugs increased maximal work load and exercise capacity at 2 h after administration. This effect was sustained in the IS-5-MN group also at 16 h after administration. In the bupranolol group only the increase in exercise capacity was sustained for 16 h after administration. Combined therapy has only slightly improved the effect of monotherapy. The frequency of anginal episodes and sublingual nitroglycerin consumption were reduced with both forms of monotherapy, but more with IS-5-MN. Combined therapy increased the effect of bupranolol but not of IS-5-MN. In conclusion, sustained-release IS-5-MN exerts a significant increase in exercise tolerance for at least 16 h after dosing, in monotherapy as well as in combined therapy with beta-blocker. The efficacy during the prolonged therapy over 12 days was without attenuation.

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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
          : 14-18
          Affiliations
          Städtisches Krankenhaus, Bobingen, FRG
          Article
          174919 Cardiology 1991;79:14–18
          10.1159/000174919
          1760823
          © 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.

          Page count
          Pages: 5
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