COMPARISON OF EFFICACY OF DIFFERENT LONG-ACTING NITRATES DRUG COMPOUNDS IN PATIENTS WITH STABLE ANGINA

Aim. To compare antianginal and antiischemic efficacy and tolerability of buccal nitroglycerine – Trinotrolong (TNL) medication and most commonly used pills of isosorbide-5-mononitrate (I5M) and isosorbide dinitrate (ID) in patients with stable angina.

Material and methods. The study is multicenter, randomized, openlabel. Totally 71 pt studied, mean age 59,5±4,3 y., with not less than three angina episodes (AEp) per week at the background of usual physical activity and positive exercise stress test on tread-mill (EST). After randomization all patients were taking by the cross-method the TNL 4-8 mg/day “on demand” and I5M or ID 40 mg/day during next 6 weeks each. Efficacy of the drugs was assessed by the method of repeated EST, quantity of AEp and pill (dosages) taken of the short-acting nitroglycerine.

Results. All medications studied led to a significant relevant increase of the threshold exertion duration as at the 1st day of intake (coupled TNL), as during regular intake. In contrast to TNL and I5M, regular intake of ID led to relevant decrease of the threshold exertion duration comparing to the 1st day of its intake (p=0,04), that witnessed for tolerance. At the background of all medications studied, there was relevant decrease of AEp per week and of long-acting nitrates intake, without significant differences between drugs. There were no any significant differences in the prevalence of side effects, of those – the most often headache occurred with slight decrease with the continuous intake.

Conclusion. Significant stable antianginal and antiischemic efficacy of TNL is achieved by transmucous load of buccal nitroglycerine into the body, fast effect development, its prolongation, that makes possible to use TNL by the “on demand” schedule, just before the expected physical and emotional activity. 

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