Previtali M, Salerno J A, Tavazzi L, Ray M, Medici A, Chimienti M, Specchia G, Bobba P
Am J Cardiol. 1980 Apr;45(4):825-30. doi: 10.1016/0002-9149(80)90128-9.
The effectiveness of nifedipine in treating angina pectoris at rest was evaluated in 14 patients with frequent ischemic episodes associated with S-T segment elevation or depression. The trial consisted of (1) a 48 hour control period; (2) a placebo period and a period of treatment with nifedipine of 48 hours each; and (3) a second placebo period and a second period of treatment with nifedipine of 24 hours each. The efficacy of treatment was evaluated by continuous electrocardiographic recording to detect painless ischemic episodes. During coronary angiography coronary spasm was demonstrated in five patients. The ergonovine maleate test was positive in seven of eight patients. No statistically significant difference was found in the mean daily number of ischemic episodes between the control period and the first placebo period, or between the control and the second placebo periods. Nifedipine produced a highly significant reduction in the mean daily number of episodes compared with the response to placebo during the first as well as the second period. Nifedipine is effective in angina at rest caused by coronary arterial spasm. The prevention of ischemia may be related to the ability of nifedipine to decrease calcium-dependent coronary muscle tone and to prevent coronary spasm.
对14例伴有S-T段抬高或压低的频繁缺血发作患者，评估了硝苯地平治疗静息性心绞痛的疗效。试验包括：(1) 48小时的对照期；(2) 安慰剂期和各为期48小时的硝苯地平治疗期；(3) 第二个安慰剂期和各为期24小时的第二个硝苯地平治疗期。通过连续心电图记录以检测无痛性缺血发作来评估治疗效果。在冠状动脉造影期间，5例患者显示有冠状动脉痉挛。8例患者中有7例麦角新碱试验呈阳性。在对照期与第一个安慰剂期之间，或对照期与第二个安慰剂期之间，缺血发作的平均每日次数未发现有统计学显著差异。与第一个和第二个时期对安慰剂的反应相比，硝苯地平使发作的平均每日次数显著减少。硝苯地平对由冠状动脉痉挛引起的静息性心绞痛有效。缺血的预防可能与硝苯地平降低钙依赖性冠状动脉张力及预防冠状动脉痉挛的能力有关。
