Angina pectoris chronic stable

Posicor Jun-97 Jun-98 Hypertension and chronic stable angina pectoris 41 million... 

In a placebo controlled, double-blind, multicenter study with 47 chronic stable angina pectoris patients Pirsidomine showed significant hypotensive, anti-ischemic and antianginal effects [126]. 

It is used for arterial hypertension, chronic, stable angina pectoris, preventing angina pectoris, and for ischemic-type abnormalities of brain blood flow. Synonyms of this drug are nerdipina, carden, and others. 

Maseri A. Medical therapy of chronic stable angina pectoris. Circnlation 1990 82 2258-62. 

Chronic, stable angina pectoris PO Initially, lOOmg/dayassingleordivided dose.Increase at weekly (or longer) intervals. Maintenance 100 50 mg/day. PO (Extended-Release) Initially 100 mg/day as single dose. May increase at least at weekly intervals until optimum clinical response achieved. Maximum 200 mg/day. 

Klein WW, Jackson G, Tavazzi L. Efficacy of monotherapy compared with combined antianginal drugs in the treatment of chronic stable angina pectoris a meta-analysis. Coron Artery Dis. 2002 13 427-436. 

Pectoris Aspirin Trial (SAPAT) Group. Double-blind trial of aspirin in juimary prevention of myocardial infarction in patients with stable chronic angina pectoris. Lancet 1992 340 1421-1425. 

DiBianco R, Alpert J, Katz RJ, Spann J, Chester E, Ferri DP, Larca LJ, Costello RB, Gore JM, Eisenman MJ. Bepridil for chronic stable angina pectoris results of a prospective multicenter, placebo-controlled, dose-ranging study in 77 patients. Am J Cardiol 1984 53(1) 35 1. 

Leon MB, Rosing DR, Bonow RO, Lipson LC, Epstein SE. Clinical efficacy of verapamil alone and combined with propranolol in treating patients with chronic stable angina pectoris. Am J Cardiol 1981 48(l) 131-9. 

Picano E PISA (Persantin In Stable Angina) study group. Dipyridamole in chronic stable angina pectoris a randomized, double blind, placebo-controlled, parallel group study. Eur Heart J 2001 22(19) 1785-93. 

Braun S, van der Wall EE, Emanuelsson H, Kobrin I. Effects of a new calcium antagonist, mibefradil (Ro 40-5967), on silent ischemia in patients with stable chronic angina pectoris a multicenter placebo-controlled study. The Mibefradil International Study Group. J Am Coll Cardiol 1996 27(2) 317-22. 

Alpert JS, Kobrin I, DeQuattro V, Friedman R, Shepherd A, Fenster PE, Thadani U. Additional antianginal and anti-ischemic efficacy of mibefradil in patients pretreated with a beta blocker for chronic stable angina pectoris. Am J Cardiol 1997 79(8) 1025-30. 

Ankier SI, Fay L, Warrington SJ, Woodings DF. A multicentre open comparison of isosorbide-5-mononitrate and nifedipine given prophylactically to general practice patients with chronic stable angina pectoris. J Int Med Res 1989 17(2) 172-8. 

Muiesan ML, Boni E, Castellano M, Beschi M, Cefis G, Cerri B, Verdecchia P, Porcellati C, Pollavini G, Agabiti-Rosei E. Effects of transdermal nitroglycerin in combination with an ACE inhibitor in patients with chronic stable angina pectoris. Eur Heart J 1993 14(12) 1701-8. 

Indications Chronic stable angina pectoris Category Cardiotonic agent Half-life 2 hours... 

Verapamil (80 mg p.o. q. 6 to 8 hours) is indicated in the management of Prinzmetal s or variant angina or unstable or chronic, stable angina pectoris verapamil (0.075 to 0.15 mg/kg rv pnsh over a 2-minnte period) is indicated in the treatment of supraventricnlar tachyarrhythmias verapamil (240 to 480 mg p.o. daily) is indicated in the prevention of recurrent paroxysmal supraventricular tachycardia verapamil (240 to 320 mg p.o. daily) is indicated in the control of the ventricular rate in digitalized patients with chronic atrial flatter and/or fibrillation and verapamil (80 mg p.o. t.i.d.) is indicated in the management of hypertension. 

Mechanism of Relief of Symptoms of Angina Pectoris The nitrate-induced relief of anginal pain has been ascribed to a decrease in cardiac work secondary to the fall in systemic arterial pres-sine. The ability of nitrates to dilate epicardial coronary arteries is modest the bulk of evidence favors a reduction in myocardial work and thus in myocardial oxygen demand as their primary effect in chronic stable angina. Paradoxically, high doses of organic nitrates may reduce blood pres-sine to such an extent that coronary flow is compromised reflex tachycardia and adrenergic... 

Task forces from the ACC and the AHA have published guidelines that are useful in the selection of appropriate initial therapy for patients with chronic stable angina pectoris (www.americanheart.org). Patients with coronary artery disease should be treated with aspirin and a P adrenergic receptor antagonist (particularly if there is a history of prior MI). The guidelines also... 

O Hara MJ, Khurmi NS, Bowles MJ, Raftery EB. Diltiazem and propranolol combination for the treatment of chronic stable angina pectoris. Clin Cardiol (1987) 10,115-23. 

Findlay IN, MacLeod K, Gillen G, Elliott AT, Aitchison T, Dargie HI A double blind placebo controlled comparison of verapamil, atenolol, and their combination in patients with chronic stable angina pectoris. Br Heart J (1987) 57, 336-43. 

Peripheral arterial occlusion can be the initial manifestation of cardiac or systemic disease. At times, patients with chronic stable claudication may experience abrupt shortening of the distance at which claudication occurs, and this may be the only symptomatic evidence of an acute arterial occlusion either by embolization of by thrombus formation on a pre-existing arterial stenosis. The situation is not chronic and stable any more, but acute and unstable. As ischemia becomes more severe, the patient with chronic peripheral arterial disease develops ischemic pain at rest. The pathophysiologic mechanisms and the clinical presentation parallel the evolution of chronic stable angina pectoris to unstable angina and acute coronary syndromes. 

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