Abstract
The potent relaxation of vascular smooth muscle which occurs upon introduction of a calcium antagonist into either a muscle bath or when administered to a patient provides the basis for their increasing use in patients disabled by angina pectoris due to either occlusive coronary artery disease or coronary artery spasm. As discussed elsewhere in this symposium, the relative selectivity of calcium blockers for vascular smooth muscle over cardiac muscle, allows their use in therapeutic ranges with minimal negative inotropic effects. In the late 1970’s, case reports in uncontrolled studies began reporting the efficacy of calcium blockers for the treatment of coronary artery spasm.(1–5) Subsequently, it was found that these agents could be highly effective in patients with typical exertional angina as well. This paper will review the clinical applications of the calcium blockers in patients with either coronary artery spasm or exertional angina due to occlusive coronary artery disease.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Muller JE, Gunther SJ: Nifedipine therapy for Prinzmetal’s angina. Circulation (57): 137–139, 1978.
Gunther S, Green L, Muller JE, Mudge GH Jr, Grossman W: Inappropriate coronary vasoconstriction in patients with coronary artery disease: a role for nifedipine? Am J Cardiol (44): 793–801, 1979.
Heupler FA Jr, Proudfit WL: Nifedipine therapy for refractory arterial spasm. Am J Cardiol (44): 798–805, 1979.
Yasue H, Omote S, Takizawa A, Nagao M, Miwa K, Tanaka S: Exertional angina pectoris caused by coronary arterial spasm: effects of various drugs. Am J Cardiol (43): 647–651, 1979.
Rosenthal SJ, Ginsburg R, Lamb IH, Baim DS, Schroeder JS: Efficacy of diltiazem for control of symptoms of coronary arterial spasm. Am J Cardiol (46): 1027–1031, 1980.
Prinzmetal M, Kennamer R, Merliss R, Wada T, Bor N: Angina pectoris. I. A variant form of angina pectoris: preliminary report. Am J Med (27): 375–388, 1959.
Hart NJ, Silverman ME, King SB: Variant angina pectoris caused by coronary artery spasm. Am J Med (56): 269–274.
Schroeder JS, Rosenthal S, Ginsburg R, Lamb IH: Medical therapy of Prinzmetal’s variant angina. Chest (78): 231–233, 1980.
Rosenthal SJ, Ginsburg R, Lamb IH, Baim DS, Schroeder JS: Efficacy of diltiazem for control of symptoms of coronary arterial spasm. Am J Cardiol (46): 1027–1032, 1980.
Rosenthal SJ, Lamb IH, Schroeder JS, Ginsburg R: Long-term efficacy of diltiazem for control of symptoms of coronary artery spasm. Circulation Research/Suppl. I, Calcium Channel-Blocking Drugs (52): I-153–I157, 1983.
Antman E, Muller JE, Goldberg S, MacAlpin R, Rubenfire M, Tabatznik B, Liang C, Heupler F, Achuff S, Reichek N, Geltman E, Kerin NZ, Neff RK, Braunwald E: Nifedipine therapy for coronary-artery spasm: experience in 127 patients. N Engl J Med (302): 1269–1273, 1980.
Hill JA, Feldman RL, Conti R, Hill CK, Pepine CJ: Long-term responses to nifedipine in patients with coronary spasm who have an initial favorable response. Am J Cardiol (52): 26–29, 1983.
Johnson SM, Mauritson DR, Willerson JT, Hillis LD: A controlled trial of verapamil for Prinzmetal’s variant angina. N Engl J Med (304): 862–866, 1981.
Johnson SM, Mauritson DR, Willerson JT, Cary JR, Hillis LD: Verapamil administration in variant angina pectoris. JAMA (245): 1849–1851, 1981.
Johnson SM, Mauritson DR, Willerson JT, Hillis LD: Comparison of verapamil and nifedipine in the treatment of variant angina pectoris: preliminary observations in 10 patients. Am J Cardiol (47): 1295–1300, 1981.
Rich S, Ford LE, Al-Sadir J: The angiographic effect of ergonovine and nifedipine in coronary artery spasm. Circulation (62): 1127–1130, 1980.
Tiefenbrunn AJ, Sobel BE, Gowda S, McKnight RC, Ludbrook PA: Nifedipine blockade of ergonovine-induced coronary arterial spasm: angiographic documentation. Am J Cardiol (48): 184–187, 1981.
Hung J, Lamb IH, Connolly SJ, Jutzy KR, Goris ML, Schroeder JS: The effect of diltiazem and propranolol, alone and in combination, on exercise performance and left ventricular function in patients with stable effort angina: a double-blind, randomized, and placebo-controlled study. Circulation (68): 560–567, 1973.
Hossack KF, Bruce RA: Improved exercise performance in persons with stable angina pectoris receiving diltiazem. Am J Cardiol (47): 95–101, 1981.
Hossack KF, Pool PE, Steele P, Crawford MH, DeMaria AN, Cohen LS, Ports TA: Efficacy of diltiazem in angina on effort: a multicenter trial. Am J Cardiol (49): 567–572, 1982.
Hossack KF, Bruce RA, Ritterman JB, Kusumi F, Trimble S: Divergent effects of diltiazem in patients with exertional angina. Am J Cardiol (49): 538–546, 1982.
Mueller HS, Chahine RA: Interim report of multicenter double-blind, placebo- controlled studies of nifedipine in chronic stable angina. Am J Med (71): 645–657, 1981.
Moskowitz RM, Piccini PA, Nacarelli GV, et al: Nifedipine therapy for stable angina pectoris: Preliminary results of effects on angina frequency and treadmill exercise response. Am J Cardiol (44): 811–816, 1979.
Kenmure ACF, Scruton JH: A double-blind controlled trial of the antianginal efficacy of nifedipine compared with propranolol, in Jatene AD, Lichtlen PR, (eds): Third International Adalat Symposium. Excerpta Medica, Amsterdam, 1976, pp 268–271.
Lynch P, Dargie H, Krikler S, et al: Objective assessment of antianginal treatment: A double-blind comparison of propranolol, nifedipine, and their combination. Br Med J (281): 184–187, 1980.
Pine MB, Citron PD, Bailly DJ, et al: Verapamil versus placebo in relieving stable angina pectoris. Circulation (65): 17–22, 1982.
Subramanian VB, Lahiri A, Paramasivan R, et al: Verapamil in chronic stable angina. Lancet (1): 841–844, 1980.
Subramanian VB, Bowles M, Lahira A, et al: Long-term antianginal action of verapamil assessed with quantitated serial treadmill stress testing. Am J Cardiol (48): 529–535, 1981.
Johnson SM, Mauritson DR, Corbett JR, et al: Double-blind, randomized, placebo-controlled comparison of propranolol and verapamil in the treatment of patients with stable angina pectoris. Am J Med (71): 443–451, 1981.
Frishman WH, Klein NA, Strom JA, et al: Superiority of verapamil to propranolol in stable angina pectoris: A double-blind, randomized crossover trial. Circulation (65) (Suppl. 1): 51–59, 1982.
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1984 Martinus Nijhoff Publishing, Boston
About this chapter
Cite this chapter
Schroeder, J.S. (1984). Antianginal Effects of Calcium Antagonists. In: Sperelakis, N., Caulfield, J.B. (eds) Calcium Antagonists. Developments in Cardiovascular Medicine, vol 39. Springer, Boston, MA. https://doi.org/10.1007/978-1-4613-3810-9_8
Download citation
DOI: https://doi.org/10.1007/978-1-4613-3810-9_8
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4613-3812-3
Online ISBN: 978-1-4613-3810-9
eBook Packages: Springer Book Archive