Additional antianginal and anti-ischemic efficacy of Mibefradil in patients pretreated with a beta blocker for chronic stable angina pectoris

Joseph S. Alpert, Isaac Kobrin, Vincent DeQuattro, Richard Friedman, Alexander Shepherd, Paul E. Fenster, Udho Thadani

Research output: Contribution to journalArticlepeer-review

23 Scopus citations

Abstract

This study assessed the safety, tolerability, and efficacy of mibefradil when added to β-blocker monotherapy in patients with chronic stable angina pectoris. Two hundred five patients were randomized to receive double-blind treatment with either placebo (n = 70), mibefradil 25 mg (n = 67), or mibefradil 50 mg (n = 68) for 2 weeks. Exercise tolerance tests (ETTs) were performed at the end of the run-in (baseline) and double-blind treatment periods, and patients maintained an anginal diary. Compared with placebo, treatment with mibefradil 50 mg resulted in significant increases in exercise duration (36 ± 51 seconds; p = 0.036), time to onset of angina (48 ± 65 seconds; p = 0.002), and time to persistent 1-mm ST-segment depression (47 ± 77 seconds; p = 0.004). Greater reductions in heart rate, blood pressure, and the rate-pressure product were more apparent at each stage of the ETT in the 50-mg mibefradil group than in the placebo group. Daily treatment with mibefradil 50 mg was associated with a significant decrease in the number of weekly anginal attacks (-2.1 ± 4.0, p = 0.020) compared with placebo. The addition of mibefradil to existing β-blocker therapy was well tolerated. Dizziness was the most frequently reported adverse event in the mibefradil 50-mg dose, and occurred with an incidence of 4.4%. The addition of mibefradil 50 mg, administered once daily, to patients on stable β-blocker therapy produced additive antianginal and anti-ischemic effects and was well tolerated.

Original languageEnglish (US)
Pages (from-to)1025-1030
Number of pages6
JournalAmerican Journal of Cardiology
Volume79
Issue number8
DOIs
StatePublished - Apr 15 1997

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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