Mohammad Fahim Ameer, Syed Zahed Rasheed.
24 hour stable anti-anginal effect of retard Verapamil, Diltiazem & Nifedipine.
Pak Heart J Jan ;38(3-4):35-40.

Background: Calcium autogonist are widely used as antianginal agents. Retard forms of calcium antagonists maintain anti anginal effect throughout 24 hours. However the duration of effect and antianginal effect of retard form of calcium antagonists has not been widely investigated. Objective: The objective of this study was to asses the duration of effect, antianginal effect and tolerability of retard forms of nifedipine, verapamil and diltiazem. Methods: Patients with typical exertional chest pain and atleast 1mm ST-segment depression on ECG were included in this study. Each patient under went control ETT. Then ETT was done after giving drugs at 4, 12 and 18 hours with each drug in all patients after an interval of 3-4 days. Mean ST-segment depression of all leads was calculated and A% ST-segment depression was derived. The drug was considered effective if A% ST-segment depression was more than 30%. Result: With 20mg retard nifedipine, the A% ST-segment depression after 4 hours was 35.8% and after 12 hours was 45.2% with 120 mg retard verapamit, it was 36.4% after 4 hours 31.4% after 12 hours 25% after 18 hours with 240 mg of retard verapmit, it was 58.6% after 4 hours, 58.1% after 12 hours and 46.5% after 18 hours, with 90mg retard diltiazem it was 65.1% after 4 hours 49.9% after 12 hours and 16.4% after 18 hours. Conclusion: All calcium antagonists in retard form have shown good anti ischemic and anti anginal effect throughout 24 hours.

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