TREATMENT OPTIMIZATION IN PATIENTS WITH STABLE ANGINA PECTORIS: FOCUS ON VERAPAMIL SR
Abstract
Possibilities of angina pectoris pharmacotherapy are analyzed. Achievement of target heart rate (HR) 55-60 beats per minute in these patients is possible due to three classes of antianginal medications that slow down HR: beta blockers (BB), If-channel inhibitors, nondihydropyridine calcium channel blockers (CCB). Nondihydropyridine CCB verapamil in slow release (SR) formulation is focused. The main results of randomized clinical trials (APSIS, VHAS, CRIS, EVERESTH, VAMPHYRE, INVEST, VESPA, DAVIT-1, DAVIT-2), which have proven efficacy and safety, are presented. Verapamil SR is indicated for the treatment of angina pectoris in patients without history of myocardial infarction (MI); angina patients experienced MI without systolic heart failure and with contraindications to BB; angina with arterial hypertension; left ventricular diastolic dysfunction; peripheral arteries obliterating atherosclerosis; silent myocardial ischemia; vasospastic angina; angina associated with supraventricular cardiac arrhythmias (especially in permanent atrial fibrillation) except Wolff-Parkinson-White and Lown-Ganong-Levine syndromes; after coronary angioplasty and the placement of bare metal stents.
About the Author
I. M. Sokolov
Saratov State Medical University named after V.I. Razumovsky
Russian Federation
Russian Federation
References
1. Management of stable angina pectoris. Recommendations of the Task Force of the European Society of Cardiology. Eur Heart J 2006; 27(11):1341-1381.
2. National guidelines for diagnosis and treatment of stable angina. Kardiovaskulyarnaya terapiya i profilaktika 2008; 7(6) suppl 4: 1-46. Russian (Национальные рекомендации по диагностике и лечению стабильной стенокардии. Кардиоваскулярная терапия и профилактика 2008; 7(6) Приложение 4: 1-46).
3. Boden W.E,. Vray M., Eschwege E. et al. Heart rate-lowering and -regulating effects of once-daily sustained-release diltiazem. Clin Cardiol 2001; 24(1): 73-91.
4. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation. JACC 2006; 38(4):1266 I–1266.
5. Fox K.M., Mulcahy D., Findlay I. et al. Long-term compliance with beta-blockers, an-giotensin-converting enzyme inhibitors, and statins after acute myocardial infarction. Eur Heart J 2006;27:1153—1158.
6. Karpov Iu.A., Deev A.D. The program ALTERNATIVA — investigation of antianginal efficacy and tolerability of coraxan (ivabradine) and assessment of quality of life of patients with stable angina: results of an epidemiological stage. Kardiologiia 2008;48(5):30-5. Russian (Карпов Ю.А., Деев А.Д. Программа АЛЬТЕРНАТИВА — исследование антиангинальной эффективности и переносимости кораксана (ивабрадина) и оценка качества жизни пациентов со стабильной стенокардией: результаты эпидемиологического этапа. Кардиология 2008; 5: 30–35).
7. National guidelines for diagnosis and treatment of chronic heart failure. Serdechnaya nedostatochnost 2010; 11 (1): 3-62 Russian (Национальные рекомендации по диагностике и лечению хронической сердечной недостаточности. Сердечная недостаточность 2010; 11 (1): 3-62).
8. Swedberg K., Komajda M., Böhm M. et al on behalf of the SHIFT Investigators. Ivabra-dine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet 2010; 376: 875-885
9. The Danish Study Group on Verapamil in Myocardial Infarction. Verapamil in acute myocardial infarction. Eur Heart J 1984; 5: 516-528.
10. The Danish Study Group on Verapamil in Myocardial Infarction. The effect of verapamil on mortality and major events after acute myocardial infarction. (The Danish Verapamil Infarction Trial II - DAVIT II). Am J Cardiol 1990; 66: 33I-40I.
11. Hjalmarson A., Elmfeldt D., Herlitz J. et al: Effect on mortality of metoprolol in acute myocardial infarction: A double–blind randomized trial. Lancet 1981; 2: 823-827.
12. The MIAMI Trial Research Group. Metoprolol in acute myocardial infarction (MIAMI). A randomized placebo–controlled international trial. Eur Heart J 1985; 6:199–226.
13. Rengo F., Carbonin P., Pahor M. et al., CRIS Investigators. A controlled Trial of verapamil in patients after acute myocardial infarction: results of the Calcium Antagonist Reinfarction Italian Study (CRIS). Am J Cardiol 1996; 77: 365-369.
14. Rehnqvist N., Hjemdahl P., Billing E. et al. Effects of metoprolol vs verapamil in patients with stable angina pectoris. The Angina Prognosis Study in Stockholm (APSIS). Eur Heart J 1996; 17: 76–81.
15. Zanchetti A., Rosei E.A., Palu C.D. et al. The Verapamil in Hypertension and Atherosclerosis Study (VHAS): Results of long-term randomized treatment with either verapamil on chlortalidone on carotid-media thickness. J Hypertens 1998;16:1667-1576.
16. Libretti A., Catalono M. Lipid profile during antihypertensive treatment. The SLIP study. Drugs 1993;46 suppl 2:16-23.
17. Guidelines Committee. 2003 European Society of Hypertension - European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertension 2003; 21:1011-10537.
18. Novo S., Alaimo G., Abrignani M.G. et al. Noninvasive blood pressure monitoring evaluation of verapamil slow-release 240-mg anti-hypertensive effectiveness. J Cardiovasc Pharmac 1989; 13 (Suppl 4): S38-41.
19. Lefrandt J.D., Heitmann J., Sevre K. et al. Contrasting effects of verapamil and amlodipine on cardiovascular stress responses in hypertension. Br J Clin Pharmacol 2001; 52:687-692.
20. Mancia G., Laurent S., Agabiti–Rosei E. et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens 2009; 27: 2121–2158.
21. Pepine C.J., Handberg E., Cooper-De-Hoff R. et al. A Calcium Antagonist vs Non-Calcium Antagonist Hypertension Treatment Strategy for Patients With Coronary Artery Disease. The International Verapamil-Trandolapril Study (INVEST): A Randomized Controlled Trial. JAMA 2003; 290(21): 2805-16.
22. Sever P.S., Dahlof B., Poulter N.R. et al for the ASCOT Investigators. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scan-dinavian Cardiac Outcomes Trial (ASCOT-BPLA): a multicentre randomized controlled trial. Lancet 2005; 366: 895-906.
23. Bestehorn H.P., Neumann F.J., Büttner H.J. et al. Verapamil Slow-Release for Prevention of cardiovascular Events After Angioplasty. J Am Coll Cardiol 2004;43:2160-75.
Review
For citations:
Sokolov I.M. TREATMENT OPTIMIZATION IN PATIENTS WITH STABLE ANGINA PECTORIS: FOCUS ON VERAPAMIL SR. Rational Pharmacotherapy in Cardiology. 2011;7(3):347-355. (In Russ.) https://doi.org/10.20996/1819-6446-2011-7-3-347-355
Views: 816
Email this article 