[Therapy of coronary heart disease with nitroglycerin patches. Behavior of anti-ischemic effectiveness in continuous administration and following patch free interval].

Subsequent to the finding of a rapidly attenuated anti-ischemic effect on use of high-dose nitroglycerin patch treatment in patients with coronary artery disease as well as contradictory results obtained with low-dose patch treatment, there are still no reliable guidelines for the use of transdermal nitroglycerin patch therapy. Accordingly, this study was carried out in ten patients with angiographically-documented coronary artery disease, stable exercise-induced angina pectoris and reproducible ST-segment depression, to assess the extent and duration of antianginal and anti-ischemic action of nitroglycerin patch treatment at an intermediate dosage of 15 mg/24 hours after the initial application, after renewed patch application on the second day and after patch application on the third day which had been preceded by a ten-hour patch-free interval in the night. At 2.5 hours after initial application of the nitroglycerin patch there was a 64% reduction in exercise-induced ST-segment depression from 2.6 mm +/- 0.21 (SEM) to 0.93 mm +/- 0.29 (p less than 0.001) (Figures 1 and 2). The exercise capacity to onset of 1 mm ST-segment depression was increased 132% from 191 watt X min +/- 15 (SEM) to 442 watt X min +/- 47 (p less than 0.001), (Figure 3). Eight hours after the initial patch application, exercise-induced ST-segment depression was reduced 37% from 2.6 mm +/- 0.19 to 1.65 mm +/- 0.18 (p less than 0.01); the exercise capacity to onset of 1 mm ST-segment depression was increased 39% from 178 watt X min +/- 18 to 245 watt X min +/- 19 (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)