Key result
Heart rate increased significantly from 74 to 90 beats/min 5 to 30 minutes before ischemia onset (p<0.001), while propranolol and nitroglycerin altered ischemic event distribution oppositely.
Why the study?
Does treatment with propranolol or nitroglycerin alter the distribution of ischemic events by heart rate in ambulant patients with coronary artery disease?
Population
21 ambulant patients with proven coronary artery disease
Comparison
Propranolol and nitroglycerin vs Placebo
Design
Cohort, placebo-controlled (for the drug therapy sub-analysis)
Follow-up
504 hours of continuous monitoring total
Authors
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HR rises precede daily-life ischemia and drugs shift event rates differently; hypothesis-generating for rate-specific therapy, should not yet change practice.
RCT (n=21)
Placebo-controlled
Does treatment with propranolol or nitroglycerin alter the distribution of ischemic events by heart rate in ambulant patients with coronary artery disease?
p-value: p=<0.001
Significant increases in heart rate occur 5 to 30 minutes before ischemia onset during daily life, and different anti-ischemic drugs have distinct effects on ischemia occurring at different heart rates.
McLenachan et al. (1991) conducted an RCT in Coronary artery disease (n=21). Propranolol and nitroglycerin vs. Placebo was evaluated on Heart rate increase before the onset of ischemia (p=<0.001). Heart rate increased significantly from 74 to 90 beats/min 5 to 30 minutes before ischemia onset (p<0.001), while propranolol and nitroglycerin altered ischemic event distribution oppositely.
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