Anti-ischemic effects of atenolol versus nifedipine in patients with coronary artery disease and ambulatory silent ischemia

The anti-ischemic effects of atenolol and nifedipine were compared in a randomized double-blind crossover manner in 24 patients with stable exertional angina and transient silent ischemia during ambulatory electrocardiographic (ECG) monitoring. Both atenolol and nifedipine were effective (p less tha...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1991-03, Vol.17 (4), p.963-969
Main Authors: DEEDWANIA, P. C, CARBAJAL, E. V, NELSON, J. R, HAIT, H
Format: Article
Language:English
Subjects:
Angina Pectoris - drug therapy
Antianginal agents. Coronary vasodilator agents
Atenolol - therapeutic use
Biological and medical sciences
Cardiovascular system
Circadian Rhythm - physiology
Coronary Disease - complications
Coronary Disease - diagnosis
Coronary Disease - drug therapy
Coronary Disease - etiology
Double-Blind Method
Electrocardiography, Ambulatory
Humans
Male
Medical sciences
Middle Aged
Nifedipine - therapeutic use
Pharmacology. Drug treatments
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Summary:The anti-ischemic effects of atenolol and nifedipine were compared in a randomized double-blind crossover manner in 24 patients with stable exertional angina and transient silent ischemia during ambulatory electrocardiographic (ECG) monitoring. Both atenolol and nifedipine were effective (p less than 0.005) in reducing the average number and duration of transient ischemic events, but therapy with atenolol was associated with a significantly greater reduction in the mean number (p less than 0.05) and duration (p less than 0.01) of silent ischemic events. Analyses of the silent ischemic activity during the morning hours revealed that only therapy with atenolol produced a significant reduction in the average duration per patient (139 +/- 54 vs. 1,609 +/- 468 s, p less than 0.01) and in the average duration of silent ischemia per event between 6 AM and 12 noon (62 +/- 21 vs. 208 +/- 24 s, p less than 0.005). There were fewer adverse experiences during therapy with atenolol. These results show that although both atenolol and nifedipine are effective in reducing silent ischemic events, treatment with atenolol is associated with significantly greater efficacy, particularly on the morning surge of silent myocardial ischemia.
ISSN:0735-1097
1558-3597