[Discontinuous drug release as an alternative to interval therapy in the treatment of coronary heart disease with nitroglycerin patches].

In ten patients with angiographically-documented coronary artery disease, according to a double-blind, placebo-controlled protocol, the antiischemic and antianginal actions of a new transdermal nitroglycerin patch system with discontinuous drug release (7.5 mg/24 hours, two-thirds of which is released within the first twelve hours) were assessed on three consecutive days to determine whether effective longterm treatment is possible (Figure 1). At 2.5 hours after initial application, as compared with placebo, the active drug led to a reduction in exercise-induced ST-segment depression of 55.9% (p less than 0.001; Figure 2), the exercise capacity to onset of 1 mm ST-segment depression increased 129% (p less than 0.05; Figure 3), angina pectoris during exercise was incurred in only 20% of the patients (Figure 4). At twelve hours, the corresponding effects were attenuated at -44%, +114% and +60%. 24 hours after patch application, an appreciable effect could no longer be detected. After renewed patch application on the second day, as compared with the initial application, the actions on ST-segment depression and exercise capacity were diminished about 20%. Similarly, there was an increase in the number of patients who developed angina during exercise. At twelve hours, there was more marked attenuation of the effects on all three parameters than that which had already been observed on the first day. At 24 hours, there were no significant effects. At 2.5 hours after renewed patch application on the third day, the effects on ST-segment depression, exercise capacity and incurrence of angina pectoris were essentially similar those seen after the second application.(ABSTRACT TRUNCATED AT 250 WORDS)