Key result
Antianginal therapy reduced the frequency of chest pain attacks compared to a placebo period (1.1 attacks/day), while the diurnal distribution of attacks remained unchanged.
Why the study?
Does medical therapy alter the incidence and circadian rhythm of chest pain attacks in patients with angina at rest?
Observational (n=187)
Does medical therapy alter the incidence and circadian rhythm of chest pain attacks in patients with angina at rest?
Angina at rest exhibits a circadian rhythm peaking between 5 and 8 A.M., which is preserved despite medical therapy but becomes more uniform in patients with severe coronary artery disease.
Answers are grounded in this paper and cite their sources.
Reduces attack frequency without altering circadian rhythm in resting angina; leaves open whether rhythm-targeted strategies warrant prospective testing.
We studied 187 patients with angina at rest in order to evaluate the circadian rhythm of chest pain attacks. All subjects were followed for 7 days in absence of therapy (placebo period) and then with therapy (nifedipine, metoprolol, or isosorbide dinitrate). During the placebo period (1309 days) 1466 attacks were recorded, on an average of 1.1 per day. Most episodes occurred between 5 and 8 A.M. The incidence of chest pain attacks was much lower between 9 A.M. and 4 P.M. During the period with therapy, a reduction of painful episodes was observed, while the diurnal distribution remained unchanged. Furthermore, we studied the relationship between circadian distribution of anginal attacks and the extension of coronary damage in the 76 patients who underwent coronary angiography. Alterations of diurnal distribution of chest pain attacks were noted in subjects with normal coronary arteries and those with one-vessel and two-vessel disease. Patients with three-vessel disease or left main coronary artery stenosis showed more uniform distribution of their attacks.
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Mattioli et al. (1986) conducted an observational in Angina at rest (n=187). Antianginal therapy (nifedipine, metoprolol, or isosorbide dinitrate) vs. Placebo period (absence of therapy) was evaluated on Frequency and circadian rhythm of chest pain attacks. Antianginal therapy reduced the frequency of chest pain attacks compared to a placebo period (1.1 attacks/day), while the diurnal distribution of attacks remained unchanged.
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