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Treatment of Transient Myocardial Ischemia in Patients with Stable Angina: A Comparative Study of Verapamil Slow‐Release and Nifedipine Plus Propranolol

We compared the effect of verapamil slow-release (VSR) and the combination of nifedipine plus propranolol on transient myocardial ischemia in a double-blind study comprising 20 patients with proven coronary artery disease and chronic stable angina. According to the results of 24-h Holter-monitoring recording, patients were divided into two groups: 10 patients with fixed coronary reserve and 10 patients with variable coronary reserve. The number of ischemic events was reduced with both therapies: from 12 ± 10 at baseline to 3.4 ± 4.0 (p < 0.05) with verapamil and to 3.9 ± 7.0 (p < 0.05) with nifedipine plus propranolol (N + P). When total ischemic burden was measured, findings were similar: It was reduced from 104 ± 196 min to 27 ± 57 (p < 0.05) with N + P and to 17 ± 18 min with verapamil in patients with fixed coronary reserve and from 36 ± 44 to 5 ± 9 min (p < 0.05) with verapamil and to 5 ± 10 min with N + P in patients with a variable coronary reserve. VSR shows antiischemic efficacy similar to that of the combination of N + P in treatment of transient myocardial ischemia in patients with stable angina.