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November 1, 1988European Heart Journal

Dilitiazem in Comparison with metoprolol in stable angina pectoris

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Key result

Diltiazem increased total exercise duration compared to metoprolol (+16% vs +4%, P=0.05) in male patients with chronic stable angina.

Why the study?

Does diltiazem improve exercise tolerance and reduce anginal attacks compared to metoprolol in male patients with chronic stable angina?

Population

33 male patients with chronic stable angina

Comparison

Diltiazem 240 mg with allowed dose adjustment to… vs Metoprolol 200 mg with allowed dose adjustment…

Design

RCT, blind

Follow-up

15 weeks

Authors

RDR.B. VAN DUKKLK.I. LieBeiersdorf (Germany)HCH. J. G. M. CRUNSUniversity of Groningen

Discussion

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Implication

Supports preferring diltiazem to metoprolol for exercise tolerance in men with stable angina; extends head-to-head RCT data versus beta-blockers.

Study Design

Type

RCT (n=33)

Blinding

Blind

Structured PICO

Does diltiazem improve exercise tolerance and reduce anginal attacks compared to metoprolol in male patients with chronic stable angina?

P
Population
33 male patients with chronic stable angina evaluated in a 15-week blind cross-over study comparing diltiazem and metoprolol.
I
Intervention
Diltiazem 240 mg (60 mg q.i.d.) with allowed dose adjustment to 360 mg (120 t.i.d.) for 6 weeks
C
Comparator
Metoprolol 200 mg (100 mg b.i.d.) with allowed dose adjustment to 400 mg (200 b.i.d.) for 6 weeks
O
Outcome
Number of anginal attacks and exercise variables (exercise duration, time to angina, maximal ST-depression)surrogate

Main Result

Absolute Event Rate: 16% vs 4%

p-value: p=0.05

Diltiazem is a safe and effective alternative to metoprolol that improves exercise tolerance in patients with chronic stable angina.

Cite This Study

DUK et al. (1988) conducted an RCT in chronic stable angina (n=33). Diltiazem vs. Metoprolol (200 to 400 mg daily) was evaluated on total exercise duration (p=0.05). Diltiazem increased total exercise duration compared to metoprolol (+16% vs +4%, P=0.05) in male patients with chronic stable angina.

synapsesocial.com/papers/6aa0277ffb5e17fb76d562c2https://doi.org/10.1093/oxfordjournals.eurheartj.a062429
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Sustained-release diltiazem versus metoprolol in stable angina pectoris1989 · 16 citations
  2. 2Beneficial effects of high-dose diltiazem in patients with persistent effort angina on beta-blockers and nitrates: a randomized, double-blind, placebo-controlled cross-over study.1985 · 62 citations
  3. 3Diltiazem in the Treatment of Mild or Moderate Essential Hypertension. Comparison with Metoprolol in a Crossover Double‐Blind Trial1984 · 44 citations
  4. 4Increased exercise tolerance and reduced electrocardiographic ischemia with diltiazem in patients with stable angina pectoris.1982 · 68 citations
  5. 5Short- and long-term efficacy of high-dose oral diltiazem for angina due to coronary artery disease: a placebo-controlled, randomized, double-blind crossover study.1983 · 99 citations