Antianginal and anti‐ischemic effects of nisoldipine and ramipril in patients with syndrome X

摘要

Background: Syndrome X is defined as typical angina pectoris, positive treadmill exercise test, negative intravenous ergonovine test, and angiographically normal coronary arteries. Hypothesis: in the present study, we investigated the anti‐ischemic and antianginal effects of nisoldipine and ramipril in patients with syndrome X. Methods: After 2 weeks of the first wash‐out period, 18 patients (7 men, 11 women, age 46 ± 10 years) were given nisoldipine (NIS) 5 mg twice daily for 4 weeks, and after 2 weeks of the second wash‐out period, the same patients were given ramipril (RAM) 2.5 mg once daily for 4 weeks. A treadmill exercise test with modified Bruce protocol was performed at the end of each period. Results: The time to angina in exercise (607 ± 115 s‐650 ± 117 s, p = 0.006, vs. 630 ± 114 s‐660 ± 123 s, p = 0.02), total exercise time (612 ± 110 s‐656 ± 114 s, p = 0.0008, vs. 630 ± 114 s‐660 ± 123 s, p = 0.02), and maximum MET value (11.09 ± 2.08–11.86 ± 2.04, p = 0.0016, vs. 11.42 ± 2.09–12.2 ± 2.26, p = 0.01) were increased significantly with both therapy modalities. The time to 1 mm ST‐segment depression (123 ± 93 s ‐ 220 ± 172 s, p = 0.002) was increased significantly with NIS therapy. The time to ST‐segment recovery (434 ± 268 s‐330 ± 233 s, p = 0.016 vs. 443 ± 289 s‐370 ± 278 s, p = 0.012), the frequency of anginal attacks per week (1.27 ± 1.4–0 ± 0.38, p = 0.005, vs. 1 ± 1.32–0.33 ± 0.59, p = 0.028), and the need for sublingual nitroglycerin (1.16 ± 1.29–0.11 ± 0.32, p = 0.005, vs. 0.94 ± 1.16–0.27 ± 0.57, p = 0.012) were decreased significantly with both drugs. Conclusion: We observed that 10 mg daily NIS and 2.5 mg daily RAM have similar anti‐ischemic and antianginal effects in patients with syndrome X.