ACUTE EFFECTS OF NIFEDIPINE, DILTIAZEM AND THEIR COMBINATION IN PATIENTS WITH CHRONIC STABLE ANGINA - A DOUBLE-BLIND, RANDOMIZED, CROSS-OVER, PLACEBO-CONTROLLED STUDY

We evaluated the acute therapeutic effects of the oral administration of n (10mg) and diltiazem (120 mg) alone and in combination in 16 patients with effort angina. The 16 patients (13 men and three women; mean age 59±7 years) performed a symptom-limited bicycle exercise stress test 3 h after placebo or active substance administration. Maximal work load, exercise duration and time to 1 mm ST segment depression were significantly increased and ST depression at peak exercise was significantly decreased by the combination of drugs. N and diltiazem alone similarly improved exercise duration as markedly as their combination. One patient stopped the test after all three treatments for angina associated with ST depression > 2mm. The combination of drugs yielded the best symptomatic effect: only four patients complained of angina in comparison to eight and seven patients after diltiazem and n respectively.Nifedipine and diltiazem are effective and safe antianginal drugs. Some patients respond better to one drug than to the other. Patients who remain symptomatic in spite of maximal doses of a single drug may derive some benefit from combination therapy. © 1993 The European Society of Cardiology.