Effects of treatment with once-daily nifedipine CR and twice-daily benidipine on prevention of symptomatic attacks in patients with coronary spastic angina pectoris—Adalat Trial vs Coniel in Tokyo against Coronary Spastic Angina (ATTACK CSA)

• Published in: Journal of cardiology 2010-03, Vol.55 (2), p.238-247
• Main Authors: Oikawa, Yuji, MD, Matsuno, Syunsuke, MD, Yajima, Junji, MD, Nakamura, Masato, MD, FJCC, Ono, Tsuyoshi, MD, Ishiwata, Sugao, MD, FJCC, Fujimoto, Yo, MD, Aizawa, Tadanori, MD, FJCC
• Format: Article
• Language: English
• Subjects: Acetylcholine; Angina Pectoris - prevention & control; Benidipine; Blood Pressure - drug effects; Calcium-channel blockers; Cardiovascular; Coronary spastic angina; Coronary Vasospasm - chemically induced; Coronary Vasospasm - prevention & control; Dihydropyridines - administration & dosage; Electrocardiography, Ambulatory; Ergonovine; Female; Heart Rate - drug effects; Humans; Male; Middle Aged; Nifedipine - administration & dosage; Nifedipine CR; Nitrates - therapeutic use; Vasodilator Agents - administration & dosage
• ISSN: 0914-5087; 1876-4738
• DOI: 10.1016/j.jjcc.2009.11.005

Summary Background We compared the efficacy of once-daily treatment with nifedipine CR 40 mg (NR) and twice-daily treatment with benidipine 4 mg (BD) in patients with coronary spastic angina (CSA) registered in 3 cardiovascular institutes in Tokyo. Methods and results CSA was diagnosed by an ischemic ST change during Holter ECG monitoring or drug-induced test. Thirty patients were randomly allocated to either NR or BD group. The number of symptomatic attacks and the total frequency of short-acting nitrates were examined based on the data in diaries written by patients. There were no significant differences in the baseline characteristics between the two groups. The median number (25–75% quartile) of attacks per week was significantly decreased in NR group, i.e., 1.0 (0.8–2.0) at baseline, 0.0 (0.0–1.0) after 4 weeks of treatment, and 0.0 (0.0–0.0) after 8 weeks of treatment ( P = 0.0093, P = 0.0002, Wilcoxon's rank-sum test). No significant decrease was observed in BD, i.e. 1.0 (0.5–2.0) at baseline, 1.3 (0.0–3.0) after 4 weeks, and 0.0 (0.0–1.0) after 8 weeks. The number of attacks was fewer in NR than in BD group ( P = 0.074, P = 0.015, U -test for difference). Conclusion Once-daily treatment with NR 40 mg was more effective than twice-daily treatment with BD in the prevention of CSA attacks.