Buccal Nitroglycerin and Intravenous Isosorbide Dinitrate in Unstable Angina

Publisher Website
Google Scholar
Abstract
The relative efficacy of a sustained-action buccal nitroglycerin (5-10 mg) was compared with intravenous isosorbide dinitrate (3-6 mg/h) in 30 patients with unstable angina using a double-blind protocol. A nuclear probe was used to measure left ventricular ejection and filling for 3 h after acute administration, and ECG and blood pressure were recorded. Changes from basal data were analyzed by analysis of variance. A significant improvement in symptoms was accompanied by sustained improvements in ejection fraction, ejection rate, relative cardiac output, relative stroke volume, and peak filling rate. Both produced a non-linear fall in systolic and diastolic blood pressures with time (p = 0.0084 and p = 0.004, respectively), but did not alter heart rate. Buccal nitroglycerin produced greater changes than isosorbide dinitrate in systolic blood pressure (p = 0.014), ejection fraction (p = 0.046), relative stroke volume (p = 0.0054), and relative cardiac output (p = 0.054) at 3 h. The buccal route for nitrate delivery allows earlier and easier effective therapy for the management of unstable angina, comparable to intravenous isosorbide dinitrate. This application may be extended to management of unstable angina prior to hospital admission.

This publication has 0 references indexed in Scilit: