What question did this study set out to answer?

To compare the effectiveness of calcium channel blockers combined with beta blockers against beta blocker monotherapy for exercise-induced angina.

June 1, 1999Angiology

Combination of Calcium Channel Blockers and Beta Blockers for Patients with Exercise-Induced Angina Pectoris: A Double-Blind Parallel-Group Comparison of Different Classes of Calcium Channel Blockers

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Why the study?

Does the addition of different classes of calcium channel blockers to beta blockers improve exercise tolerance and delay ischemia in patients with exercise-induced angina pectoris?

Population

335 patients with exercise-induced angina pectoris on baseline beta blocker treatment

Comparison

Amlodipine, diltiazem XR, or mibefradil added to… vs Baseline beta blocker monotherapy and…

Design

RCT, double-blind

Follow-up

10 weeks

Authors

JVJ. A. F. M. van der VringMartini Ziekenhuis MDMarcel DanielsJeroen Bosch Ziekenhuis NHN. J. HolwerdaDeakin University

Discussion

Member takes

Implication

Supports adding CCBs to beta blockers to delay exercise ischemia in angina; extends combination therapy evidence while cautioning on mibefradil tolerability.

Key Points

To compare the effectiveness of calcium channel blockers combined with beta blockers against beta blocker monotherapy for exercise-induced angina.
335 patients underwent a 10-week, double-blind, parallel-group trial with varying doses of amlodipine, diltiazem, and mibefradil.
Exercise testing was conducted using bicycle ergometry to evaluate performance and ischemic responses.
Significant effects on ST segment depression were measured compared to baseline.
All calcium channel blockers significantly delayed the onset of 1 mm ST segment depression on exercise testing (p<0.001).
Mibefradil produced the largest delays in ischemia symptoms (low dose: P<0.003, high dose: P<0.001).
Dizziness occurred significantly more in the mibefradil group, with 19 patients withdrawing due to intolerable symptoms (p<0.05).

Structured PICO

Does the addition of different classes of calcium channel blockers to beta blockers improve exercise tolerance and delay ischemia in patients with exercise-induced angina pectoris?

Population

335 patients with exercise-induced angina pectoris on baseline beta blocker treatment

Intervention

Amlodipine (5 and 10 mg), diltiazem XR (200 and 300 mg), or mibefradil (50 and 100 mg) added to baseline beta blocker treatment for 10 weeks

Comparator

Baseline beta blocker monotherapy and head-to-head comparison between the different calcium channel blockers

Outcome

Duration of exercise, amount of workload, and onset of 1 mm ST segment depression on bicycle ergometry exercise testingsurrogate

Adding calcium channel blockers with negative chronotropic properties to beta blockers delays ischemia in exercise-induced angina, but mibefradil is associated with intolerable dizziness.

Cite This Study

Vring et al. (1999) studied this question.

synapsesocial.com/papers/6a735a9355ee283707b871ef https://doi.org/10.1177/000331979905000602

Topics

Women and heart disease

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Implication

Supports adding CCBs to beta blockers to delay exercise ischemia in angina; extends combination therapy evidence while cautioning on mibefradil tolerability.

Combination of Calcium Channel Blockers and Beta Blockers for Patients with Exercise-Induced Angina Pectoris: A Double-Blind Parallel-Group Comparison of Different Classes of Calcium Channel Blockers

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Combination of Calcium Channel Blockers and Beta Blockers for Patients with Exercise-Induced Angina Pectoris: A Double-Blind Parallel-Group Comparison of Different Classes of Calcium Channel Blockers

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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Topics

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