What is the clinical evidence from this study?

Study design: RCT. Population: Stable exertional angina (n=46). Intervention: Verapamil and diltiazem vs. Placebo. Primary outcome: Angina attacks per week and treadmill time (p=<0.001).

What question did this study set out to answer?

To evaluate and compare the long-term clinical efficacy, exercise capacity improvements, and safety profiles of high-dose verapamil and diltiazem in patients with stable exertional angina.

December 1, 1984Clinical Cardiology

The efficacy and safety of high‐dose verapamil and diltiazem in the long‐term treatment of stable exertional angina

Q: What are the key findings of this study?

High-dose verapamil and diltiazem significantly reduced angina attacks (P<0.001) and increased treadmill time (P<0.001) in patients with stable exertional angina.

Q: What question did this study set out to answer?

To evaluate and compare the long-term clinical efficacy, exercise capacity improvements, and safety profiles of high-dose verapamil and diltiazem in patients with stable exertional angina.

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Key result

High-dose verapamil and diltiazem significantly reduced angina attacks (P<0.001) and increased treadmill time (P<0.001) in patients with stable exertional angina.

Why the study?

Do high-dose verapamil and diltiazem reduce angina attacks and improve exercise capacity in patients with stable exertional angina?

Population

46 patients with stable exertional angina (26 in verapamil cohort, 20 in diltiazem cohort)

Comparison

High-dose verapamil or diltiazem for an initial… vs Placebo

Design

RCT, Randomized phase, Double-blind, placebo-controlled

Follow-up

6 weeks and 12 months

Authors

DWD A WeinerBoston Medical Center CMCarolyn H. McCabeThrombolysis in Myocardial Infarction Study Group SCSally S. CutlerBoston University

Discussion

Member takes

Implication

Supports high-dose verapamil or diltiazem for stable angina; confirms RCT efficacy for symptom control and exercise capacity.

Key Points

To evaluate and compare the long-term clinical efficacy, exercise capacity improvements, and safety profiles of high-dose verapamil and diltiazem in patients with stable exertional angina.
Evaluated separate cohorts receiving high-dose verapamil (480 mg/day, n=26) or high-dose diltiazem (360 mg/day, n=20) in patients with stable exertional angina.
Conducted an initial 6-week double-blind, placebo-controlled, randomized phase followed by a 12-month open-label extension period.
Assessed weekly angina attack frequency, treadmill exercise duration, rate-pressure product during submaximal exercise, and adverse effects.
Angina attacks per week decreased significantly from 6.3 ± 7.5 to 2.5 ± 4.1 with verapamil (p < 0.001) and from 9.2 ± 7.5 to 3.0 ± 3.1 with diltiazem (p < 0.001), with therapeutic effects maintained through one year.
Treadmill exercise duration increased from 372 ± 132 s to 444 ± 108 s under verapamil (p < 0.001) and from 412 ± 175 s to 536 ± 164 s under diltiazem (p < 0.001).
Submaximal exercise rate-pressure product fell by 12% with verapamil and 7% with diltiazem (both p < 0.05), while adverse events were mild, including constipation (n=6, verapamil) as well as pedal edema and flushing (n=2 each, diltiazem).

Study Design

Type

RCT (n=46)

Blinding

Double-blind

Structured PICO

Do high-dose verapamil and diltiazem reduce angina attacks and improve exercise capacity in patients with stable exertional angina?

Population

46 patients with stable exertional angina treated with high-dose verapamil or diltiazem for 6 weeks (double-blind) followed by 12 months (open-label).

Intervention

High-dose verapamil (480 mg/day) or diltiazem (360 mg/day) for an initial 6-week phase followed by a 12-month open-label period

Comparator

Placebo (during the initial 6-week double-blind phase)

Outcome

Angina attacks per week and treadmill timepatient reported

Main Result

p-value: p=<0.001

High-dose verapamil and diltiazem are both safe and effective for the long-term reduction of angina attacks and improvement of exercise capacity in patients with stable exertional angina.

Cite This Study

Weiner et al. (1984) conducted an RCT in Stable exertional angina (n=46). Verapamil and diltiazem vs. Placebo was evaluated on Angina attacks per week and treadmill time (p=<0.001). High-dose verapamil and diltiazem significantly reduced angina attacks (P<0.001) and increased treadmill time (P<0.001) in patients with stable exertional angina.

synapsesocial.com/papers/6a92a9ce8262cd83d96245c4 https://doi.org/10.1002/clc.4960071205

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The efficacy and safety of high‐dose verapamil and diltiazem in the long‐term treatment of stable exertional angina

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

The efficacy and safety of high‐dose verapamil and diltiazem in the long‐term treatment of stable exertional angina

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Also Consider