Anti‐anginal Efficacy of a Controlled‐Release Formulation of lsosorbide‐5‐mononitrate Once Daily in Angina Patients on Chronic β‐Blockade

Abstract

Uusitalo A, Ke riltiinen 0, Hiirkonen R, Rautio P, Rehnqvist N, Engvall J, Halvorsen F-A (). Anti-anginal efficacy of a controlled-release formulation of isosorbide-5-mononitrate once daily in angina patients on chronic /?-blockade. Acta Med Scand 1988; 223: 219-25.The anti-anginal effect of a controlled-release (Durules") formulation of isosorbide-5mononitrate (5-ISMN) 60 mg, Imduf, once daily was evaluated in a randomised doubleblind, placebo-controlled, crossover study with a placebo run-in period. Each period lasted for 2 weeks. A total of 70 patients (58 men and 12 women) with stable exertional angina pectoris on j3-blockade, mean age 59 years (range 39-71), were included. Exercise testing was performed on a bicycle ergometer 3 hours after the dose at the end of each period. Anginal attacks and intake of sublingual nitroglycerin tablets were noted. Imduf in combination with a B-blocker significantly increased the total exercise capacity, the time and total work until the onset of chest pain and at 1 mm ST-depression compared with Bblockade alone. The attack rate and the nitroglycerin consumption were significantly decreased. Headache was the only significant side-effect. In conclusion, the addition of Imduf once daily to B-blockade significantly increased the anti-anginal effect.

Diagnosis and management of stable angina

“…Adding isosorbide mononitrate to a beta blocker 90 or to a CCB 91 significantly improves performance on a range of clinical endpoints. Adding nicorandil to other antianginal drugs was effective in reducing combined cardiac events.…”