Diltiazem versus glyceryl trinitrate therapy for unstable angina

Canadian Medical Association Journal 1996; 154: 1220

Source: Göbel EJA, Hautvast RWM, van Gilst WH et al: Randomised, double-blind trial of intravenous diltiazem versus glyceryl trinitrate for unstable angina pectoris. Lancet 1995; 346: 1653-1657

Because therapy with dihydropyridine calcium-channel blockers (nifedipine) in patients with unstable angina pectoris has had discouraging results, researchers in the Netherlands compared diltiazem, a non- dihydropyridine calcium-channel blocker, with glyceryl trinitrate in the treatment of 121 patients with unstable angina. The patients were randomly assigned treatment with intravenous diltiazem (25 mg bolus followed by infusion up to 25 mg/h) or intravenous glyceryl trinitrate (up to 5 mg/h). Intention-to-treat analysis showed that refractory angina alone or with myocardial infarction was significantly less common in the diltiazem group than in the glyceryl trinitrate group. The diltiazem group showed a strong trend toward better survival without ischemic events, but this was significant only for the period in which patients actually received the drug.

| CMAJ April 15, 1996 (vol 154, no 8) |