CONFRONTO TRA NISOLDIPINA E DILTIAZEM NEL TRATTAMENTO DELL'ANGINA DA SFORZO

Background. In order to evaluate the benefits of a calcium-antagonist medium-term treatment, 20 patients with effort stable angina pectoris were treated with nisoldipine in comparison to diltiazem. Methods. Twenty patients with stable effort angina completed a double-blind placebo controlled trial, comparing 10 twice daily nisoldipine per os and diltiazem 120 three times daily per os for 28 days. After wash-out, placebo and drug period, ergometer stress tests were performed. Exercise tolerance, angina frequency, nitrate consumption and side effects were evaluated. Results. Our results showed that both drugs significantly increased exercise tolerance. Exercise duration was 330 ± 107 sec after placebo, 397 ± 106 sec after nisoldipine (p <0.05) and 378 ± 99 sec after diltiazem (p <0.05). Effort angina episodes decreased from 20 after placebo to 8 after nisoldipine and diltiazem. Both drugs reduced rate-pressure product at submaximal exercise in comparison to placebo. There were no differences at peak exercise between placebo or drug periods. Both drugs similarly reduced nitrate consumption and weekly effort angina attacks. No patients referred serious side-effects. Conclusions. Nisoldipine, like diltiazem, is an effective drug in the treatment of stable effort angina. Moreover, the therapeutic effects of nisoldipine during medium-term treatment are probably related to decrease in oxygen consumption.