PERMUTATION DISTRIBUTION ESTIMATION APPLIED TO THE COMPARISON OF THE PROFILE OF THE ACTIVITY OF 2 ANTIANGINAL DRUGS

The comparison of the anti-ischemic activity of trimetazidine and prop ranolol was evaluated by multiple end points (clinical, exercise test, and ambulatory electrocardiogram [EGG] monitoring criteria) in 149 ma le patients with effort angina who received either trimetazidine 20 mg tid or propranolol 40 mg tid during a period of 3 months. The distrib ution of the standardized differences between the two treatments for e ach variable was obtained by a permutation method. The medians (estima tion of the actual difference between the two treatments) and the 5, 2 5, 75 and 95% quantiles were represented on the same diagram for all e nd points. The pattern of the standardized distribution of the differe nces showed a similar activity of both drugs on symptoms and nitrates consumption, on exercise tolerance and increase in ischemic threshold at exercise, and on ischemia recorded at ambulatory ECG monitoring. Co nversely, only propranolol decreased heart rate and rate pressure prod uct at rest as well as at exercise, underlining the difference in the mode of action of the two drugs. This descriptive technique is an attr active method to evaluate the differences between drugs considering mu ltiple criteria favouring the estimation of these differences together with their variability.