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 journalArticle

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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
JournalThe American journal of cardiology
Volume79
Issue number8
DOIs
StatePublished - Apr 15 1997

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Mibefradil
Stable Angina
Placebos
Exercise Tolerance
Exercise Test
Therapeutics
Dizziness
Heart Rate
Exercise

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Additional antianginal and anti-ischemic efficacy of Mibefradil in patients pretreated with a beta blocker for chronic stable angina pectoris. / Alpert, Joseph S.; Kobrin, Isaac; DeQuattro, Vincent; Friedman, Richard; Shepherd, Alexander; Fenster, Paul E.; Thadani, Udho.

In: The American journal of cardiology, Vol. 79, No. 8, 15.04.1997, p. 1025-1030.

Research output: Contribution to journalArticle

Alpert, Joseph S. ; Kobrin, Isaac ; DeQuattro, Vincent ; Friedman, Richard ; Shepherd, Alexander ; Fenster, Paul E. ; Thadani, Udho. / Additional antianginal and anti-ischemic efficacy of Mibefradil in patients pretreated with a beta blocker for chronic stable angina pectoris. In: The American journal of cardiology. 1997 ; Vol. 79, No. 8. pp. 1025-1030.
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