RESULTS OF TREATMENT OF ANGINA PECTORIS WITH CHOLINE THEOPHYLLINATE BY THE DOUBLE-BLIND METHOD

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Abstract
Choline theophylli-nate was tried in 72 ambulatory patients with angina pectoris. Forty-two cases received the drug, while 28 received a placebo (double-blind method.) Results proved that, in the majority of cases, no suggestive influence was involved in the results. No sedative effect was ascertained and tolerance was good. Clinical improvement resulting from the drug was remarkable but gradual in its onset. It was revealed by a decrease in the number of the attacks of pain and in their severity, as well as in the partial or total discontinuance of nitroglycerin. Working capacity and the ability to walk without pain were also increased. The ecg at rest improved only in a few exceptional cases. The ecg recorded after a two-step test was usually comparable to that recorded prior to therapy. However, this apparent lack of change was due to the fact that most patients were unable to complete the test before therapy but could complete it afterwards. When the numbers of steps in the tests before and after treatment were identical, no changes followed exertion after therapy in some cases, in contrast with the deterioration of the tracing produced by exertion before therapy. This represented an objective evidence of the effect of the drug. It is concluded that the effects are not due to a vaso-dilating action. Three possible effects are discussed: decreased load on the left ventricle, production of enzymes in the myocardium, or inactivation of pressor amines in the heart muscle. The last two would improve the utilization of O2 by the heart.