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(Chest. 1980;78:234-238.)
© 1980 American College of Chest Physicians

The Treatment of Exercise-Inducible Chronic Stable Angina with Diltiazem

Effect on Treadmill Exercise

Peter E. Pool M.D., F.C.C.P.1; Shirley C. Seagren 2; Joseph A. Bonanno M.D., F.C.C.P.3; George W. Dennish M.D., F.C.C.P.3; and Antone F. Salel M.D., F.CC.P.4

1 Associate Clinical Professor of Medicine, University of California, San Diego and Director of Cardiology, Scripps Memorial Hospital—Encinitas
2 From the Cardiopulmonary Laboratory Scripps Memorial Hospital (Encinitas), Encinitas, California
3 Assistant Clinical Professor of Medicine, University of California, San Diego
4 Chief of Medicine, Scripps Memorial Hospital—Encinitas

Although diltiazem has been shown to alleviate vasospastic angina pectoris, its effect on exercise-inducible chronic stable angina has not been objectively studied. Accordingly, the effect of diltiazem was studied in this condition with a placebo controlled double-blind randomized cross-over protocol at three dose levels (120, 180 and 240 mg/day) during graded treadmill exercise. Three end-points were evaluated: 1) time to onset of angina or fatigue if angina were eliminated; 2) time to 1 mm ST segment depression or fatigue if ST depression were eliminated; and 3) time to termination of exercise (2+ angina or fatigue). All end-points were prolonged at all dose levels. At the highest dose of 240 mg/day, time to onset angina or termination was prolonged from a placebo time of 8.0 ± 0.9 to 9.8 ± 0.9 minutes (p = <.001); time to ST depression or termination was prolonged from 7.8 ± 0.9 to 9.1 ± 0.8 minutes (p = .007); and time to termination was prolonged from 9.9 ± 0.9 to 10.8 ± 0.8 minutes (p = .02).






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Copyright © 1980 by the American College of Chest Physicians.