Effect of a new transdermal therapeutic system containing nitroglycerin on exercise capacity in patients with angina pectoris

Scardi, S; Pivotti, F; Fonda, F; Pandullo, Claudio; Castelli, Marilena; Pollavini, G.

doi:10.1016/0002-8703(85)90073-0

Cited by 57 publications

(12 citation statements)

References 19 publications

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“…[11][12][13] To our knowledge, this is the first study to demonstrate that NTG can alleviate exercise-induced ischemia 24 hours after its administration, long after the hemodynamic effects of this NO donor have subsided. The mechanism whereby nitrates induce late PC has been investigated in experimental models.…”

Section: Salient Findingsmentioning

confidence: 76%

Delayed Preconditioning-Mimetic Actions of Nitroglycerin in Patients Undergoing Exercise Tolerance Tests

et al. 2005

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Background-Nitroglycerin (NTG) induces delayed preconditioning (PC)-mimetic effects in animal models and in humans during coronary angioplasty. We tested the hypothesis that NTG mitigates ischemia and enhances functional capacity during an exercise tolerance test (ETT) in patients with coronary artery disease. Methods and Results-Twenty-eight patients with stable angina and ischemia documented by a stress test were randomized in a double-masked, crossover design to receive a titrated intravenous infusion of NTG or normal saline over 4 hours. At 24 to 28 hours after study medication infusion, each patient underwent 2 ETTs separated by a 1-week washout period.

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Section: Salient Findingsmentioning

confidence: 76%

Delayed Preconditioning-Mimetic Actions of Nitroglycerin in Patients Undergoing Exercise Tolerance Tests

et al. 2005

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“…Eleven previous studies relating to efficacy in angina pectoris have been published, of which eight have demonstrated variable clinical benefit whilst three have shown no measurable effect whatever. [8][9][10][11][12][13][14][15][16][17][18] The discrepancy between the studies is principally related to the dose regime and the presence or absence of concomitant anti-anginal medication. The three studies showing no demonstrable effect utilized a fixed dose protocol of one nitrate patch delivering 5 mg per 24 .…”

Section: Discussionmentioning

confidence: 99%

Influence of Transdermal Nitrates on Exercise Capacity in Patients with Stable Angina

Thompson

1986

Angiology

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Twenty patients completed a double-blind cross-over study to determine the influence of a transdermal preparation of Nitroglycerin on exercise performance in stable angina. Angiographically proven two or three vessel coronary disease was present in all. After a base-line exercise test the active device was titrated to efficacy or side effects and the number of patches thereafter remained constant (2-6 patches per day; mean 3.5). Patients were randomly allocated to active treatment or placebo, and further exercise tests were performed at 2 hours and 26 hours after application of the device. Patients were then crossed over after one days rest to the opposite treatment group, and exercise studies repeated. Two hours after application of transdermal nitroglycerin total exercise duration increased (mean 14.0 minutes) compared to placebo (12.5 minutes) and control (12.0 minutes) (p less than 0.05). This effect was maintained at 26 hours. Exercise time to anginal threshold (angina + 1.5 mm ST segment depression) was increased at 2 hours and 26 hours with active drug by 11% compared to placebo and by 22% in comparison to control. Double product of heart rate and blood pressure was not significantly different in treated and placebo groups. Oral nitroglycerin consumption assessed during the titration phase was reduced by 71%. It is concluded that transdermal nitroglycerin significantly increases exercise capacity in patients with stable angina, with an effect that is maintained over a 24-hour period using a single dose application.

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“…Although some of these studies have suggested sustained benefits from the patch,40,41 a demonstration of long-term efficacy seems to be most likely when nitrates are used as monotherapy. [33][34][35]42,43 Conversely, studies satisfying the criterion of including subjects on nitrate therapy alone can be criticized for bias towards long-term nitrate responders who might be less readily susceptible to tolerance. The ideal trial seems to be one using nitrates alone in previously untreated patients, although the results may not be applicable to the general population of angina sufferers.…”

Section: Transdermal Nitratesmentioning

confidence: 99%

An update on nitrate tolerance: can it be avoided?

Maxwell

Kendall

1992

Postgraduate Medical Journal

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Effect of a new transdermal therapeutic system containing nitroglycerin on exercise capacity in patients with angina pectoris

Cited by 57 publications

References 19 publications

Delayed Preconditioning-Mimetic Actions of Nitroglycerin in Patients Undergoing Exercise Tolerance Tests

Delayed Preconditioning-Mimetic Actions of Nitroglycerin in Patients Undergoing Exercise Tolerance Tests

Influence of Transdermal Nitrates on Exercise Capacity in Patients with Stable Angina

An update on nitrate tolerance: can it be avoided?

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