A DOUBLE-BLIND COMPARISON OF NICORANDIL AND METOPROLOL IN STABLE EFFORT ANGINA-PECTORIS

The antianginal activities of nicorandil, 10 and 20 mg bid, and metopr olol, 100 mg bid, were compared in patients with stable effort angina pectoris in a randomized, double-blind parallel group study lasting 7 weeks. Twenty patients were enrolled into the trial and 16 patients co mpleted the study. To evaluate the antiischemic effects of the two dru gs, a treadmill exercise test was performed after a 1-week placebo run -in period and 6 weeks of treatment. On the same occasions, weekly sub lingual nitroglycerine consumption and the number of anginal attacks w ere also recorded in the patient's diary. The total duration of exerci se increased significantly with both nicorandil, 10 and 20 mg, and met oprolol (p < 0.01). Similar improvements were observed in the time to onset of ischemia with both treatments (p < 0.01). The double product at maximal comparable workload (MAX 1) was reduced with the two drugs (p < 0.05 for nicorandil and p < 0.01 for metoprolol), while at the ma ximal exercise time (MAX 2) it was reduced with metoprolol (p < 0.01) and slightly but not significantly increased with both doses of nicora ndil. Weekly sublingual nitroglycerine consumption and anginal attacks were also significantly reduced a similar manner by both treatments ( p < 0.01). In conclusion, nicorandil, 10 and 20 mg bid, exerted an ant iischemic effect comparable with that of metoprolol in patients with s table effort angina pectoris.