Attenuation of circadian variation by combined antianginal therapy with suppression of morning and evening increases in transient myocardial ischemia

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

The circadian variation of total ischemic activity was examined during 3289 hours of ambulatory ECG monitoring in 101 patients with stable angina pectoris and proved coronary artery disease, who were not receiving any prophylactic antianginal therapy. The 101 patients displayed 411 episodes of ischemia, 312 (76%) of which were silent; a circadian rhythm was noted for the occurrence of total and silent ischemia. Thirty-eight percent of the ischemic episodes occurred between 6 AM and 12 noon, and total and silent ischemia were significantly more frequent during this period compared with the other three 6-hour periods (p less than 0.01); a lesser peak was noted in the evening. The effects of metoprolol and combined therapy with metoprolol and nifedipine on the circadian variation of ischemic activity were studied in two subgroups of patients in a random, double-blind study design (31 patients receiving metoprolol and 42 receiving combined therapy). During therapy with metoprolol the morning increase in ischemic activity was attenuated, and the highest frequency of ischemia was then noted in the evening (6 AM to 12 noon compared with 6 PM to 12 midnight; p less than 0.05). Combined therapy abolished the morning peak as did metoprolol monotherapy, but even the evening increase in ischemic activity was attenuated (p less than 0.05). The diurnal distribution of the mean heart rate at the onset of ischemia, when patients were off therapy, showed a morning increase similar to the increase in ischemic activity but no second peak in the evening.(ABSTRACT TRUNCATED AT 250 WORDS)

OriginalsprogEngelsk
TidsskriftAmerican Heart Journal
Vol/bind122
Udgave nummer3 Pt 1
Sider (fra-til)648-55
Antal sider8
ISSN0002-8703
StatusUdgivet - sep. 1991

Fingeraftryk

Metoprolol
Ambulatory Monitoring
Stable Angina
Nifedipine
Circadian Rhythm
Double-Blind Method
Coronary Artery Disease
Electrocardiography

Citer dette

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title = "Attenuation of circadian variation by combined antianginal therapy with suppression of morning and evening increases in transient myocardial ischemia",
abstract = "The circadian variation of total ischemic activity was examined during 3289 hours of ambulatory ECG monitoring in 101 patients with stable angina pectoris and proved coronary artery disease, who were not receiving any prophylactic antianginal therapy. The 101 patients displayed 411 episodes of ischemia, 312 (76{\%}) of which were silent; a circadian rhythm was noted for the occurrence of total and silent ischemia. Thirty-eight percent of the ischemic episodes occurred between 6 AM and 12 noon, and total and silent ischemia were significantly more frequent during this period compared with the other three 6-hour periods (p less than 0.01); a lesser peak was noted in the evening. The effects of metoprolol and combined therapy with metoprolol and nifedipine on the circadian variation of ischemic activity were studied in two subgroups of patients in a random, double-blind study design (31 patients receiving metoprolol and 42 receiving combined therapy). During therapy with metoprolol the morning increase in ischemic activity was attenuated, and the highest frequency of ischemia was then noted in the evening (6 AM to 12 noon compared with 6 PM to 12 midnight; p less than 0.05). Combined therapy abolished the morning peak as did metoprolol monotherapy, but even the evening increase in ischemic activity was attenuated (p less than 0.05). The diurnal distribution of the mean heart rate at the onset of ischemia, when patients were off therapy, showed a morning increase similar to the increase in ischemic activity but no second peak in the evening.(ABSTRACT TRUNCATED AT 250 WORDS)",
keywords = "Angina Pectoris, Circadian Rhythm, Coronary Disease, Double-Blind Method, Drug Therapy, Combination, Electrocardiography, Ambulatory, Humans, Metoprolol, Middle Aged, Nifedipine, Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial",
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Attenuation of circadian variation by combined antianginal therapy with suppression of morning and evening increases in transient myocardial ischemia. / Egstrup, K.

I: American Heart Journal, Bind 122, Nr. 3 Pt 1, 09.1991, s. 648-55.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Attenuation of circadian variation by combined antianginal therapy with suppression of morning and evening increases in transient myocardial ischemia

AU - Egstrup, K

PY - 1991/9

Y1 - 1991/9

N2 - The circadian variation of total ischemic activity was examined during 3289 hours of ambulatory ECG monitoring in 101 patients with stable angina pectoris and proved coronary artery disease, who were not receiving any prophylactic antianginal therapy. The 101 patients displayed 411 episodes of ischemia, 312 (76%) of which were silent; a circadian rhythm was noted for the occurrence of total and silent ischemia. Thirty-eight percent of the ischemic episodes occurred between 6 AM and 12 noon, and total and silent ischemia were significantly more frequent during this period compared with the other three 6-hour periods (p less than 0.01); a lesser peak was noted in the evening. The effects of metoprolol and combined therapy with metoprolol and nifedipine on the circadian variation of ischemic activity were studied in two subgroups of patients in a random, double-blind study design (31 patients receiving metoprolol and 42 receiving combined therapy). During therapy with metoprolol the morning increase in ischemic activity was attenuated, and the highest frequency of ischemia was then noted in the evening (6 AM to 12 noon compared with 6 PM to 12 midnight; p less than 0.05). Combined therapy abolished the morning peak as did metoprolol monotherapy, but even the evening increase in ischemic activity was attenuated (p less than 0.05). The diurnal distribution of the mean heart rate at the onset of ischemia, when patients were off therapy, showed a morning increase similar to the increase in ischemic activity but no second peak in the evening.(ABSTRACT TRUNCATED AT 250 WORDS)

AB - The circadian variation of total ischemic activity was examined during 3289 hours of ambulatory ECG monitoring in 101 patients with stable angina pectoris and proved coronary artery disease, who were not receiving any prophylactic antianginal therapy. The 101 patients displayed 411 episodes of ischemia, 312 (76%) of which were silent; a circadian rhythm was noted for the occurrence of total and silent ischemia. Thirty-eight percent of the ischemic episodes occurred between 6 AM and 12 noon, and total and silent ischemia were significantly more frequent during this period compared with the other three 6-hour periods (p less than 0.01); a lesser peak was noted in the evening. The effects of metoprolol and combined therapy with metoprolol and nifedipine on the circadian variation of ischemic activity were studied in two subgroups of patients in a random, double-blind study design (31 patients receiving metoprolol and 42 receiving combined therapy). During therapy with metoprolol the morning increase in ischemic activity was attenuated, and the highest frequency of ischemia was then noted in the evening (6 AM to 12 noon compared with 6 PM to 12 midnight; p less than 0.05). Combined therapy abolished the morning peak as did metoprolol monotherapy, but even the evening increase in ischemic activity was attenuated (p less than 0.05). The diurnal distribution of the mean heart rate at the onset of ischemia, when patients were off therapy, showed a morning increase similar to the increase in ischemic activity but no second peak in the evening.(ABSTRACT TRUNCATED AT 250 WORDS)

KW - Angina Pectoris

KW - Circadian Rhythm

KW - Coronary Disease

KW - Double-Blind Method

KW - Drug Therapy, Combination

KW - Electrocardiography, Ambulatory

KW - Humans

KW - Metoprolol

KW - Middle Aged

KW - Nifedipine

KW - Clinical Trial

KW - Comparative Study

KW - Journal Article

KW - Randomized Controlled Trial

M3 - Journal article

VL - 122

SP - 648

EP - 655

JO - American Heart Journal

JF - American Heart Journal

SN - 0002-8703

IS - 3 Pt 1

ER -