Gupta D K, Negi P C, Patial R K, Bansal S K
Indira Gandhi Medical College, Shimla.
Indian Heart J. 1995 Sep-Oct;47(5):485-8.
A prospective double blind cross over study compared the anti-ischemic effect of 20 mg of isosorbide-5-mononitrate (IS-5-MN), 60 mg of diltiazem and 100 mg of metoprolol by performing serial treadmill tests (TMTs) following oral administration of single dose of each drug in 28 patients of ischemic heart disease with positive exercise TMT. The anti-ischemic effect of IS-5-MN, diltiazem and metoprolol was evaluated by assessing the time to onset of ischemia (400.8 +/- 41.1 vs 394.1 +/- 36.0 vs 412.7 +/- 36.6 secs respectively, all p > or = 0.05), duration of ischemia (390.9 +/- 58.5 vs 447.6 +/- 65.9 vs 419.4 +/- 58.7 secs respectively, all p > or = 0.05), duration of exercise 464.0 +/- 32.9 vs 476.8 +/- 32.5 vs 502.6 +/- 31.3 secs respectively, all p > or = 0.05) and severity of ischemia by scoring system (10.0 +/- 1.5 vs 10.7 +/- 1.4 vs 9.8 +/- 1.5 respectively, all p > or = 0.05). Thus, the present study suggests that there is no significant difference in the anti-ischemic effect of IS-5-MN, diltiazem and metoprolol and also suggests that the anti-ischemic effect of metoprolol is primarily by decreasing the heart rate while IS-5-MN and diltiazem exert anti-ischemic effect probably by decreasing oxygen demand and improving coronary blood flow.
一项前瞻性双盲交叉研究，在28例运动平板试验（TMT）阳性的缺血性心脏病患者中，口服单剂量的每种药物后通过连续进行平板运动试验（TMT），比较了20毫克单硝酸异山梨酯（IS-5-MN）、60毫克地尔硫卓和100毫克美托洛尔的抗缺血作用。通过评估缺血发作时间（分别为400.8±41.1秒、394.1±36.0秒、412.7±36.6秒，所有p≥0.05）、缺血持续时间（分别为390.9±58.5秒、447.6±65.9秒、419.4±58.7秒，所有p≥0.05）、运动持续时间（分别为464.0±32.9秒、476.8±32.5秒、502.6±31.3秒，所有p≥0.05）以及采用评分系统评估的缺血严重程度（分别为10.0±1.5、10.7±1.4、9.8±1.5，所有p≥0.05），来评价IS-5-MN、地尔硫卓和美托洛尔的抗缺血作用。因此，本研究表明，IS-5-MN、地尔硫卓和美托洛尔的抗缺血作用无显著差异，还表明美托洛尔的抗缺血作用主要是通过降低心率，而IS-5-MN和地尔硫卓可能是通过降低氧需求和改善冠状动脉血流发挥抗缺血作用。
