Effects of transdermal nitroglycerin in combination with an ACE inhibitor in patients with chronic stable angina pectoris

We have previously shown that transdermal nitroglycerin mayinduce an increase in the activity of the adrenergic and therenin-angiotensin-aldosterone systems (SRAA) in patients withchronic stable angina pectoris (SA); when the activation ofthese systems is more pronounced, the antianginal effect ofthis drug seems to be reduced. The aim of this study was toevaluate the antianginal efficacy of transdermal nitroglycerinadministration (TTS-NG 10 mg. 24 h^–1) in combination withan ACE inhibitor without sulphydryl groups (BNZ, benazepril10 mg b.i.d.) in respect to placebo, or to TTS-NG or BNZ administeredas monotherapy. Twenty-four patients (21M, 3F) were admittedto this multicentre, randomized, double-blind, latin square,placebo-controlled study. Patients received all the treatments(placebo, TTS-NG, BNZ and BNZ+ TTS-NG) each for one week; atthe end of each week patients performed two exercise testi 2and 22 h post-dosing. Two hours post-dosing, exercise durationat 1 mm ST depression was significantly increased in respectto placebo during TTS-NG (P<0.05) and TTS-NG+BNZ (P<0.05)treatments. Two hours post-dosing, exercise duration at peakexercise was also increased in respect to placebo during TTS-NG(P<0.05) ana TTS-NG+BNZ (P<0.05); 22 h post-dosing theincrease in exercise duration was significant only during TTS-NG+BNZtreatment (P<0.05) in respect to placebo, but not duringTTS-NG given alone. Rate-pressure product at 1 mm ST depressionwas significantly increased 2 h post-dosing during TTS-NG treatment(P<005). In conclusion, these results suggest that ACE inhibitor administrationgiven in combination with TTS-NG can induce a statisticallysignificant increase in exercise duration in stable angina patientsin respect of placebo, 22 h post-dosing. The clinical significanceof this finding must be evaluated in further studies.     

Red Cell Enzymes and Intermediates in AGA Term Newborns, AGA Preterm Newborns and SGA Term Newborns

ABSTRACT. Red cell enzyme activities and 2,3-diphosphoglycerate and adenosine-triphosphate levels in cord blood of three groups of newborn infants were studied. The groups were classified according to birthweight in relation to intrauterine growth and gestational age. Only phos-phofructokinase, glyceraldehyde-3-phosphate dehydrogenase and enolase activity values differed significantly among the groups. The activity of phosphofructokinase was lower in small-for-date term infants (TSGA) and preterm adequate for gestational age (PTAGA) in comparison to term infants adequate for gestational age (TAGA). Glyceraldehyde-3-phosphate dehydrogenase activity was higher in TAGA, in comparison to PTAGA, with no other difference among the groups. Enolase activity was found to be higher in TSGA compared to TAGA and higher in PTAGA compared to TAGA. No differences were found between PTAGA and TSGA.