Martsevich S Iu, Kutishenko N P, Metelitsa V I
Ter Arkh. 1996;68(5):51-4.
The aim of the study was to evaluate feasibility of emergence of nitrate withdrawal syndrome consequently to discontinuation of short-term nitrate administration for coronary heart disease. 12 males with stable effort angina functional class III were subjected to 24-h Holter ECG monitoring. In a randomized cross-over trial each patient received for 3 days isosorbide dinitrate (10-30 mg 4 times a day) followed by 3-day course of placebo. The monitoring was performed on day 3 of the drug or placebo administration and on the first day of their withdrawal. Isosorbide dinitrate discontinuation had no negative effects on the patients' condition though significantly increased the number and duration of episodes of asymptomatic myocardial ischemia. 4 patients developed episodes of asymptomatic myocardial ischemia at rest which were not observed in placebo application. It is believed that much caution should be used in planning interrupted regimes of nitrates therapy in patients with severe angina pectoris.
该研究的目的是评估因冠心病短期停用硝酸盐类药物而出现硝酸盐戒断综合征的可行性。12名功能分级为III级的稳定劳力性心绞痛男性患者接受了24小时动态心电图监测。在一项随机交叉试验中，每位患者接受3天的二硝酸异山梨酯治疗（10 - 30毫克，每日4次），随后接受3天的安慰剂治疗。监测在药物或安慰剂给药的第3天以及停药的第一天进行。停用二硝酸异山梨酯对患者病情没有负面影响，但显著增加了无症状心肌缺血发作的次数和持续时间。4名患者出现了静息时无症状心肌缺血发作，而在使用安慰剂时未观察到这种情况。据信，在为重度心绞痛患者规划硝酸盐治疗的中断方案时应格外谨慎。
