EFFICACIA E TOLLERABILITA DEL DILTIAZEM RITARDO IN PAZIENTI AFFETTI DA ISCHEMIA MIOCARDICA DA SFORZO

Translated title of the contribution: Efficacy and tolerability of sustained-release Diltiazem in patients with exercise-induced myocardial ischemia

E. Pusineri, M. Chimienti, C. Falcone, P. Centeleghe, M. S. Negroni, C. Marena, L. Menicanti, L. De Ambroggi

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

Efficacy and tolerability of sustained-release Diltiazem were assessed in 12 patients (11 male, 1 female, aged 57 ± 7 years) affected by stable exercise-induced myocardial ischemia. Seven patients had angina pectoris, 5 patients had silent myocardial ischemia. Coronary artery disease was documented in all patients by coronary angiography and/or by a previous myocardial infarction. The protocol included two control exercise tests, performed in therapeutical washout, to assess the reproducibility of the ischemic threshold; afterwards sustained-release Diltiazem was given, at the dose of 120 mg twice daily. Two exercise tests were carried out, 4 and 12 hours after last dosing, both at week 1 and at week 4 of treatment. Blood samples for Diltiazem and Deacetyldiltiazem concentrations were drawn immediately before the exercise tests. The control tests were positive (ST-segment deprossion ≥0.1 mV) in all patients. The exercise tests were negative in 4 patients after 1 week of treatment, while after 4 weeks they became negative in 9 and 8 patients, 4 and 12 hours after dosing, respectively. The total exercise duration increased from a control value of 535 ± 67 sec, to 702 ± 38 and 642 ± 42 sec, in the two tests performed after 1 week, and to 774 ± 48 and 708 ± 48 sec, 4 and 12 hours after dosing, respectively, after 4 weeks of treatment. The maximum ST-segment depression decreased from 1.9 ± 0.5 in the control effort test to 0.9 ± 0.5, 1.2 ± 0.6, 0.6 ± 0.5, and 0.7 ± 0.7 mm, in the four tests carried out on treatment, respectively. Peak and trough Diltiazem plasma levels, measured after 1 and 4 weeks of treatment, were 159 ± 55, 107 ± 47, 243 ± 87, and 167 ± 77 mg/L, respectively. The concentrations of the main metabolite, Deacetyldiltiazem, paralleled the parent compound: 22 ± 10, 16 ± 8, 33 ± 13, and 26 ± 12 mg/L, respectively. The drug was well tolerated in this short-term study: only one patient complained of mild heartburn; nor sinus node, neither atrioventricular node dysfunctions were observed during the trial. These results show that sustained-release Diltiazem, when given at the dose of 120 mg twice daily, is well tolerated and maintains an antiischemic activity even 12 hours after last dosing.

Translated title of the contributionEfficacy and tolerability of sustained-release Diltiazem in patients with exercise-induced myocardial ischemia
Original languageItalian
Title of host publicationCuore
Pages213-220
Number of pages8
Volume10
Edition2
Publication statusPublished - 1993

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Efficacy and tolerability of sustained-release Diltiazem in patients with exercise-induced myocardial ischemia'. Together they form a unique fingerprint.

  • Cite this

    Pusineri, E., Chimienti, M., Falcone, C., Centeleghe, P., Negroni, M. S., Marena, C., Menicanti, L., & De Ambroggi, L. (1993). EFFICACIA E TOLLERABILITA DEL DILTIAZEM RITARDO IN PAZIENTI AFFETTI DA ISCHEMIA MIOCARDICA DA SFORZO. In Cuore (2 ed., Vol. 10, pp. 213-220)