Subramanian V B, Bowles M J, Khurmi N S, Davies A B, Raftery E B
Am J Cardiol. 1982 Oct;50(4):696-703. doi: 10.1016/0002-9149(82)91221-8.
A randomized double-blind crossover trial was performed in 32 patients with chronic stable angina to compare the antianginal actions of verapamil (120 mg 3 times daily) and nifedipine (20 mg 3 times daily). Efficacy was assessed using objective end points obtained by computer-assisted exercise testing and 24 hour ambulatory monitoring for S-T segment shift. Twenty-eight patients completed the trial. The mean exercise time to produce angina improved from 5.7 +/- 0.3 minutes (mean +/- standard error of the mean) in patients on placebo, to 7.9 +/- 0.5 minutes in those on nifedipine and 10.0 +/- 0.7 minutes in those on verapamil. Similar improvement was seen in all other objective variables. Generally verapamil produced mild bradycardia and nifedipine mild tachycardia. Four patients complained of palpitations and angina after ingestion of nifedipine and were identified by ambulatory monitoring to have tachycardia and persistent S-T depression. These opposite effects on heart rate may explain the differences in efficacy between these 2 potent calcium ion antagonists.
对32例慢性稳定型心绞痛患者进行了一项随机双盲交叉试验，以比较维拉帕米（每日3次，每次120毫克）和硝苯地平（每日3次，每次20毫克）的抗心绞痛作用。使用通过计算机辅助运动试验和24小时动态监测S-T段移位获得的客观终点来评估疗效。28例患者完成了试验。产生心绞痛的平均运动时间从服用安慰剂的患者的5.7±0.3分钟（平均值±平均值的标准误差），增加到服用硝苯地平的患者的7.9±0.5分钟，以及服用维拉帕米的患者的10.0±0.7分钟。在所有其他客观变量中也观察到了类似的改善。一般来说，维拉帕米会引起轻度心动过缓，硝苯地平会引起轻度心动过速。4例患者在服用硝苯地平后出现心悸和心绞痛，通过动态监测确定为心动过速和持续性S-T段压低。这两种强效钙离子拮抗剂对心率的相反作用可能解释了它们在疗效上的差异。
