Author + information
- Received January 7, 1985
- Revision received February 26, 1985
- Accepted April 8, 1985
- Published online August 1, 1985.
- Jules Lam, MD‡,
- Bernard R. Chaitman, MD, FACC*,a,
- Peter Crean, MD†,
- Richard Blum, MD* and
- David D. Waters, MD, FACC†
- ↵aAddress for reprints: Bernard R. Chaitman, MD, St. Louis University Medical Center, Division of Cardiology, 1325 South Grand Boulevard, St. Louis, Missouri 63104.
Maximal treadmill exercise testing at 1, 3 and 8 hours was used to assess the onset, duration and antianginal efficacy of the d1hydropyridine slow channel calciumblocking agent, nisoldipine, in an oral dose range of 5, 10 and 20 mg. A double-blind, randomized, placebo-controlled design was used involving 12 patients with stable effort angina. Exercise tolerance was significantly increased 3 hours after each dose, when the maximal beneficial effect occurred. The improvement was observed as early as 1 hour after the 10 and 20 mg dose, and persisted for 8 hours after the 20 mg dose. At 3 hours, the onset of an exercise-induced ST segment depression of 0.1 mV or greater was increased by 62 (p < 0.05), 75 (p < 0.01) and 117 seconds (p < 0.01) with the 5,10 and 20 mg dose of nisoldipine, respectively, compared with placebo. Similarly, time to onset of angina was significantly increased. The sum of exerciseinduced ST segment depression at peak exercise was significantly decreased (p < 0.05) from 8.7 ± 2.3 to 6.7 ± 1.8 and 6.4 ± 2.0 mm, respectively, after the 10 and 20 mg dose of nisoldipine. The rate-pressure product was significantly greater with nisoldipine than with placebo at the onset of ischemia and at peak exercise (22.8 ± 1.1 versus 20 ± 1.4 × 103 U for the 20 mg dose; p ± 0.01).
Thus, nisoldipine is an effective antianginal agent with a rapid onset of action that improves exercise tolerance, increases angina threshold and persists for at least 8 hours after oral dosing.
- Received January 7, 1985.
- Revision received February 26, 1985.
- Accepted April 8, 1985.
- American College of Cardiology Foundation