INTRAVENOUS MEDICATION OF NITROGLYCERIN V ERSUS NITROGLYCERIN DILTIAZEM AND NITROGLYCERIN NIFEDIPINE IN UNSTABLE ANGINA-PECTORIS

Effectiveness and tolerance of intravenous medication of nitroglycerin versus the combinations of nitroglycerin/diltiazem and nitroglycerin/ nifedipine were examined in 51 patients with unstable angina pectoris for a period of 48 h after admission to an intensive care unit. The ev alution was performed on the basis of patients' subjective statements as well as the objectively available clinical parameters such as systo lic and diastolic blood pressure, heart rate, and ST segment analysis in the 12-channel and long-term ECG. In agreement with comparable resu lts of the ST segment analysis in the 12-channel and long-term ECG as well as the patients' statements regarding the number and duration of ischemia, the results indicate a definitely better effect of the combi nation nitroglycerin/calcium antagonists compared to the medication of nitroglycerin only. The number and duration of ischemia were signific antly reduced (p < 0.05) in comparison to the nitroglycerin medication . Although the difference was statistically not significant, with rega rd to efficacy and safety a marked trend of superiority of the combina tion nitroglycerin/diltiazem compared to the combination nitroglycerin /nifedipine was shown. Each of the three medication types were well to lerated. It has been striking that five myocardial infarctions occurre d in the nitroglycerin/nifedipine group compared to only one myocardia l infarction in the other two groups.