Uchida T, Kaneko N, Tanino S, Ogawa H, Iwasaki T, Horikawa Y, Sumiyoshi T, Hosoda S
Department of Cardiology, Heart Institute of Japan, Tokyo.
Coron Artery Dis. 1994 Sep;5(9):773-7.
The efficacy of intravenous infusion of diltiazem was compared with that of isosorbide dinitrate (ISDN) for the early treatment of unstable angina.
Sixty-four patients with at least 70% organic stenosis of the culprit artery and prolonged rest angina were enrolled. Coronary angiography was performed on admission. Subsequently, patients were randomly assigned to receive either intravenous diltiazem or ISDN. Coronary angiography was repeated when the angina was under control, and the findings were compared with those on admission.
Diltiazem was more effective than ISDN, and symptoms were resolved in 84% of the diltiazem group compared with 47% of the ISDN group (P = 0.0038). Repeat coronary angiography showed that the degree of stenosis remained unchanged in the majority of patients (n = 47, 75.8%). There was no difference between the two groups with regard to the coronary angiographic findings.
Since diltiazem was more effective than ISDN even though the coronary angiographic findings of the two groups were similar, it is possible that some action other than vasodilatation (such as a direct protective effect on the myocardium) may be responsible for the remission of unstable angina.
比较静脉输注地尔硫䓬与硝酸异山梨酯（ISDN）对不稳定型心绞痛早期治疗的疗效。
纳入64例罪犯血管有机狭窄至少70%且静息性心绞痛持续时间延长的患者。入院时行冠状动脉造影。随后，患者被随机分配接受静脉注射地尔硫䓬或ISDN。心绞痛得到控制时重复冠状动脉造影，并将结果与入院时的结果进行比较。
地尔硫䓬比ISDN更有效，地尔硫䓬组84%的患者症状得到缓解，而ISDN组为47%（P = 0.0038）。重复冠状动脉造影显示，大多数患者（n = 47，75.8%）的狭窄程度保持不变。两组冠状动脉造影结果无差异。
由于尽管两组冠状动脉造影结果相似，但地尔硫䓬比ISDN更有效，因此除血管扩张作用外的其他作用（如对心肌的直接保护作用）可能是不稳定型心绞痛缓解的原因。
