Antianginal Response to Once-Daily Diltiazem CD in Patients Receiving Concomitant β-Blockers,Long-Acting Nitrates,or Both |
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Authors: | Dr. Gary V Heller M.D. Ph.D. Dr. Marandapalli Sridharan M.D. Dr. John Morse M.D. Dr. Stephen Glasser M.D. Dr. C. L. Beach Pharm.D. Diltiazem CD Study Group |
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Affiliation: | 1. Department of Cardiology, Veterans Administration Medical Center, Augusta, Georgia;2. San Diego, California, Kansas City, Missouri;3. Tampa, Florida, Kansas City, Missouri;4. Medical Research Department, Hoechst Marion Roussel, Inc., Kansas City, Missouri |
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Abstract: | Study Objective . To determine the safety and efficacy of diltiazem CD 180 mg administered once/day in patients with chronic stable angina inadequately controlled with β-blockers, long-acting nitrates, or both. Design . Multicenter, randomized, double-blind, placebo-controlled, parallel-group trial. Setting . Medical clinics in the private and academic sectors. Patients . Of 172 patients, 170 completed the 2-week double-blind treatment period. Interventions . Patients received either diltiazem CD 180 mg or placebo once/day in combination with existing antianginal therapy. Measurements and Main Results . The time to termination of exercise tolerance testing, 24 hours after the dose increased significantly in the diltiazem CD group (37.2 sec) compared with the placebo group (21.3 sec, p=0.0438). Time to onset of angina during exercise testing also increased (57.6 vs 35.0 sec, respectively, p=0.0324), as did time to moderate angina (37.5 vs 20.6 sec, respectively, p=0.0354). The rates of total angina attacks and of angina attacks on exertion were significantly reduced in the diltiazem CD group versus placebo (p<0.05). Significant reductions in systolic and diastolic blood pressures and heart rate-blood pressure product measured at rest, submaximum exercise, and exercise termination were observed in diltiazem CD-treated patients compared with placebo (p<0.05). The frequency of treatment-related adverse events was identical in the two groups, 15.1%. Conclusion . Diltiazem CD 180 mg once/day is an effective, safe, and beneficial initial dosage when added to existing antianginal therapy. |
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