Perhexilene Maleate in Treatment of Angina Pectoris

Lyon, LeonardJ.; Fisch, Solomon; Nevins, Michael A.; Henry, Sharon

doi:10.1016/s0140-6736(71)91783-1

Cited by 26 publications

(4 citation statements)

References 4 publications

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“…The side-effects reported in this trial are qualitatively similar to those reported in other 2-1 and subsided with dosage adjustment Similarly, weight loss is recognized as occurring in patients receiving perhexiline maleate 23,6,10,13,[15][16][17]19 Although it may be due in part to a slight diuretic action,g the mechanism is not completely understood. Elevation of the levels of serum enzymes has been reported by 0thers.~p~~.l3 The absence of significant changes in this study probably relates to the short 4-week treatment period.…”

Section: Discussionsupporting

confidence: 72%

Perhexiline maleate in the treatment of angina pectoris in patients awaiting coronary artery bypass surgery

Armstrong

1977

Current Medical Research and Opinion

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Twenty-Jive patients with angina pectoris due to coronary artery disease who had not responded to other medical therapji and who were on the waiting list ,for coronary bypass surgery were treated over a period of 4 weeks with perhexiline maleate (100 mg to 400 mglday) in addition to their other therapji. There was an 80% reduction in the average number of both anginal attacks and nitroglycerin requirement when the pre-treatment week and the 4th week of perhexiline maleate therapy were compared (p

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Section: Discussionsupporting

confidence: 72%

Perhexiline maleate in the treatment of angina pectoris in patients awaiting coronary artery bypass surgery

Armstrong

1977

Current Medical Research and Opinion

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“…Perhexiline is a myocardial "metabolic" agent that was introduced in the 1970s as a prophylactic anti-anginal agent which was initially presumed to be a coronary vasodilator. Perhexiline proved to be an extremely effective treatment for exertional angina, whether in monotherapy [20] or in combination with other agents [21]. Despite its early success, its use was rapidly declined after reports of serious hepato-and neurotoxicity associated with long-term administration, which was poorly understood at that time.…”

Section: Perhexilinementioning

confidence: 99%

New Developments in Anti-Anginal Therapy: Roles of Ivabradine, Allopurinol and of Agents Modifying Myocardial Metabolism

Nguyen¹,

Chong²,

Chan³

et al. 2014

WJCD

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Over the last 20 years, it has emerged that, while surgical revascularisation of extensive ischaemic heart disease may have prognostic advantages, the main issues considered regarding individual management are usually those of symptomatic improvement only. The major impetus towards invasive intervention is therefore failure of prophylactic anti-anginal therapy. On the other hand, many patients, especially the elderly, now present the clinical problem of ongoing angina without residual invasive options. There is an ongoing need for more effective anti-anginal therapies. Of the currently available major classes of prophylactic anti-anginal agents, neither nitrates, β-blockers nor calcium antagonists generally produce marked improvements in exercise duration. Three areas of new therapeutic development in anti-anginal therapy are worthy of note. These involve the sinus node inhibitor ivabradine, high dose allopurinol (xanthine oxidase inhibitor) and a new class of "metabolic modulators" represented by perhexiline, trimetazidine and probably ranolazine. The current review addresses the therapeutic potential of these agents. Notably, all of these "new" drugs are potentially suitable for management of angina in the setting of impaired left ventricular systolic function, and they may also be utilized in patients with angina independent of the presence of coronary disease (for example in hypertrophic cardiomyopathy). The current evidence for efficacy and potential future development in this area are reviewed.

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“…Several randomized studies have shown that treatment with P may be useful in patients with ischemic disease in optimal medical management with haemodynamic drugs, such as betablockers, nitrates, and calcium-channel blockers, allowing a reduction in the frequency of anginal episodes and in the use of sublingual nitroglycerin, as well as significant improvements in exercise tolerance [102][103][104][105]. In one randomized, double-blind, placebo-controlled trial of 17 patients with refractory angina on combination therapy, 65% of patients administered P for 3 months, noted improvements in ischemic symptoms during exercise, compared with 18% of patients given placebo [106].…”

Section: Perhexilinementioning

confidence: 99%

Optimization of Cardiac Metabolism in Diabetes Mellitus

Vitale¹,

Collins

2008

CPD

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Cardiovascular disease is a major health problem in all over the world. The prevalence of type 2 diabetes mellitus has been rapidly increasing, together with the risk for cardiovascular events. Patients with diabetes, and/or with insulin resistance as well, have an impaired myocardial metabolism of glucose and free fatty acids (FFA) and accelerated and diffuse atherogenesis, with involvement of peripheral coronary segments. Significant metabolic alterations in diabetic patients are the decreased utilization of glucose and the increase in muscular and myocardial FFA uptake and oxidation, occurring as a consequence of the mismatch between blood supply and cardiac metabolic requirements. These metabolic changes are responsible both for the increased susceptibility of the diabetic heart to myocardial ischemia and for a greater decrease of myocardial performance for a given amount of ischemia, compared to non diabetic hearts. A therapeutic approach aimed at an improvement of cardiac metabolism, through manipulations of the utilization of metabolic substrates, may improve myocardial ischemia and left ventricular function. Modulation of myocardial FFA metabolism, in addition to optimal medical therapy, should be the key target for metabolic interventions in patients with coronary artery disease and diabetes. In diabetic patients the effects of modulation of FFA metabolism should be even greater than those observed in patients without diabetes.

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Perhexilene Maleate in Treatment of Angina Pectoris

Cited by 26 publications

References 4 publications

Perhexiline maleate in the treatment of angina pectoris in patients awaiting coronary artery bypass surgery

Perhexiline maleate in the treatment of angina pectoris in patients awaiting coronary artery bypass surgery

New Developments in Anti-Anginal Therapy: Roles of Ivabradine, Allopurinol and of Agents Modifying Myocardial Metabolism

Optimization of Cardiac Metabolism in Diabetes Mellitus

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