FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Volume 302:1269-1273 June 5, 1980 Number 23 Next

	Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Abstract

We report clinical experience with the coronary vasodilator nifedipine in 127 patients with symptoms of myocardial ischemia associated with electrocardiographic or angiographic evidence, or both, of coronary-artery spasm. In the majority of patients conventional antianginal therapy including nitrates and beta-adrenergic blockers failed, and in one third of the patients at least one episode of ventricular tachycardia developed during an attack of angina. Nifedipine (40 to 160 mg every 24 hours) significantly reduced the mean weekly rate of anginal attacks from 16 to two (P less than 0.001). Similar marked reductions in the nitroglycerin requirement were noted. In 63 per cent of the patients complete control of anginal attacks was achieved, and in 87 per cent the frequency of angina was reduced by at least 50 per cent. Nifedipine was generally well tolerated, with only 5 per cent of the patients requiring termination of the drug because of intolerable side effects. This experience with nifedipine suggests that it is a highly effective drug for the treatment of coronary-artery spasm and variant angina.

This article has been cited by other articles:

• Yasue, H., Mizuno, Y., Harada, E., Itoh, T., Nakagawa, H., Nakayama, M., Ogawa, H., Tayama, S., Honda, T., Hokimoto, S., Ohshima, S., Hokamura, Y., Kugiyama, K., Horie, M., Yoshimura, M., Harada, M., Uemura, S., Saito, Y., for the SCAST (Statin and Coronary Artery Spasm Tr, (2008). Effects of a 3-Hydroxy-3-Methylglutaryl Coenzyme A Reductase Inhibitor, Fluvastatin, on Coronary Spasm After Withdrawal of Calcium-Channel Blockers. J Am Coll Cardiol 51: 1742-1748 [Abstract] [Full Text]  
• Authors/Task Force Members, , Bassand, J.-P., Hamm, C. W., Ardissino, D., Boersma, E., Budaj, A., Fernandez-Aviles, F., Fox, K. A.A., Hasdai, D., Ohman, E. M., Wallentin, L., Wijns, W., ESC Committee for Practice Guidelines (CPG), , Vahanian, A., Camm, J., De Caterina, R., Dean, V., Dickstein, K., Filippatos, G., Kristensen, S. D., Widimsky, P., McGregor, K., Sechtem, U., Tendera, M., Hellemans, I., Gomez, J. L. Z., Silber, S., Funck-Brentano, C., Document Reviewers, , Kristensen, S. D., Andreotti, F., Benzer, W., Bertrand, M., Betriu, A., De Caterina, R., DeSutter, J., Falk, V., Ortiz, A. F., Gitt, A., Hasin, Y., Huber, K., Kornowski, R., Lopez-Sendon, J., Morais, J., Nordrehaug, J. E., Silber, S., Steg, P. G., Thygesen, K., Tubaro, M., Turpie, A. G.G., Verheugt, F., Windecker, S. (2007). Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology. Eur Heart J 28: 1598-1660 [Full Text]  
• Fihn, S. D., Williams, S. V., Daley, J., Gibbons, R. J. (2001). Guidelines for the Management of Patients with Chronic Stable Angina: Treatment. ANN INTERN MED 135: 616-632 [Abstract] [Full Text]  
• Abernethy, D. R., Schwartz, J. B. (1999). Calcium-Antagonist Drugs. NEJM 341: 1447-1457 [Full Text]  
• Gibbons, R. J., Chatterjee, K., Daley, J., Douglas, J. S., Fihn, S. D., Gardin, J. M., Grunwald, M. A., Levy, D., Lytle, B. W., O'Rourke, R. A., Schafer, W. P., Williams, S. V., Ritchie, J. L., Gibbons, R. J., Cheitlin, M. D., Eagle, K. A., Gardner, T. J., Garson, A. Jr, Russell, R. O., Ryan, T. J., Smith, S. C. Jr (1999). ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina). J Am Coll Cardiol 33: 2092-2197 [Full Text]  
• Owa, M., Origasa, H., Saito, M., Owa, M. (1997). Predictive Validity of the Braunwald Classification of Unstable Angina for Angiographic Findings, Short-Term Prognoses, and Treatment Selection. ANGIOLOGY 48: 663-671 [Abstract]  
• Castello, R., Alegria, E., Merino, A., Soria, F., Martinez-Caro, D. (1988). Syndrome of Coronary Artery Spasm of Normal Coronary Arteries. Clinical and Angiographic Features. ANGIOLOGY 39: 8-15 [Abstract]  
• (1986). Drugs Five Years Later: Nifedipine in Myocardial Ischemia, Systemic Hypertension, and Other Cardiovascular Disorders. ANN INTERN MED 105: 714-729 [Abstract]  
• Conti, C. R., Hill, J. A., Feldman, R. L., Mehta, J. L., Pepine, C. J. (1986). Analytic Review: Treatment of Coronary Artery Spasm and Variant Angina. J Intensive Care Med 1: 66-74 [Abstract]  
• Bursztyn, M., Tordjman, K., Grossman, E., Rosenthal, T. (1986). Hypertensive Crisis Associated With Nifedipine Withdrawal. Arch Intern Med 146: 397-397 [Abstract]  
• CARROL, W. (1985). Nifedipine and Ureteral Colic. ANN INTERN MED 102: 864-864 [Abstract]  
• (1983). Cardiovascular Diseases: An Annotated Bibliography of Recent Literature: References to Journal Articles and Other Papers. ANN INTERN MED 98: 679-685 [Abstract]  
• Winniford, M. D., Willerson, J. T., Hillis, L. D. (1982). Calcium Antagonists in the Treatment of Individuals with Ischemic Heart Disease. ANGIOLOGY 33: 522-539 [Abstract]  
• BERGER, K., McCALLUM, R. W. (1982). Nifedipine in the Treatment of Achalasia. ANN INTERN MED 96: 61-62 [Abstract]  
• Beltran, P., Lichstein, E., Sanders, M., Hollander, G., Greengart, A., Jonas, S. (1982). Coronary Artery Spasm Appearing as Syncope. Arch Intern Med 142: 192-194 [Abstract]  
• Braunwald, E. (1981). Coronary Artery Spasm: Mechanisms and Clinical Relevance. JAMA 246: 1957-1959 [Abstract]  
• Kirshenbaum, H. D., Ockene, I. S., Alpert, J. S. (1981). The Spectrum of Coronary Artery Spasm: The Variable Variant. JAMA 246: 354-359 [Abstract]  
• SUSSMAN, E. J., GOLDBERG, S., POLL, D. S., MACVAUGH, H. III, SIMSON, M. B., SILBER, S. A., KASTOR, J. A. (1981). Surgical Therapy of Variant Angina Associated with Nonobstructive Coronary Disease. ANN INTERN MED 94: 771-774 [Abstract]  
• Johnson, S. M., Mauritson, D. R., Willerson, J. T., Cary, J. R., Hillis, L. D. (1981). Verapamil Administration in Variant Angina Pectoris: Efficacy Shown by ECG Monitoring. JAMA 245: 1849-1851 [Abstract]  
• STONE, P. H., ANTMAN, E. M., MULLER, J. E., BRAUNWALD, E. (1980). Calcium Channel Blocking Agents in the Treatment of Cardiovascular Disorders. Part II: Hemodynamic Effects and Clinical Applications. ANN INTERN MED 93: 886-904 [Abstract]