SHORT-AND LONG-TERM EFFECTS OF MOLSIDOMINE RETARD AND MOLSIDOMINE NONRETARD ON EXERCISE CAPACITY AND CLINICAL STATUS IN PATIENTS WITH STABLE ANGINA - A MULTICENTER RANDOMIZED DOUBLE-BLIND CROSSOVER PLACEBO-CONTROLLED TRIAL

A multicenter, randomized, double-blind, crossover, placebo-controlled study was conducted in 90 isosorbide dinitrate responders showing sta ble angina to compare the efficacy of molsidomine retard, 8 mg b.i.d., with that of molsidomine, 4 mg t.i.d., for 6 weeks. Total work perfor mance (workload x min) was significantly improved, compared with basel ine and placebo until 8 and 12 h after molsidomine and molsidomine ret ard administration, respectively. ST-segment depression decreased sign ificantly under the two treatments at 60 W as well as at maximal exerc ise. The rate-pressure product (heart rate x systolic blood pressure) decreased and increased significantly at submaximal and maximal exerci se level, respectively. All these effects remained significant after 6 -week treatment, with only the ST segment showing a nonsignificant ten dency to improvement at maximal work. The frequency of anginal attacks and of sublingual nitroderivative-tablets consumption decreased signi ficantly with molsidomine, 4 mg, and molsidomine retard, 8 mg. However , overall results showed that the latter form reduces myocardial ische mia more efficiently at submaximal exercise level, has a more prolonge d effect on exercise tolerance, and maintains it at a somewhat higher level after 6-week treatment.