Selection of medical treatment in stable angina pectoris: results of the International Multicenter Angina Exercise (IMAGE) Study. 1995

D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
Divisione di Cardiologia, IRCCS, Policlinico S. Matteo, Pavia, Italy.

OBJECTIVE The present study was designed to investigate which characteristics of anginal symptoms or exercise test results could predict the favorable anti-ischemic effect of the beta-adrenergic blocking agent metoprolol and the calcium antagonist nifedipine in patients with stable angina pectoris. BACKGROUND The characteristics of anginal symptoms and the results of exercise testing are considered of great importance for selecting medical treatment in patients with chronic stable angina pectoris. However, little information is available on how this first evaluation may be used to select the best pharmacologic approach in individual patients. METHODS In this prospective multicenter study, 280 patients with stable angina pectoris were enrolled in 25 European centers. After baseline evaluation, consisting of an exercise test and a questionnaire investigating patients' anginal symptoms, the patients were randomly allocated to double-blind treatment for 6 weeks with either metoprolol (Controlled Release, 200 mg once daily) or nifedipine (Retard, 20 mg twice daily) according to a parallel group design. At the end of this period, exercise tests were repeated 1 to 4 h after drug intake. RESULTS Both metoprolol and nifedipine prolonged exercise tolerance over baseline levels; the improvement was greater in the patients receiving metoprolol (p < 0.05). Multivariate analysis revealed that low exercise tolerance was the only variable associated with a more favorable effect within each treatment group. Metoprolol was more effective than nifedipine in patients with a lower exercise tolerance or with a higher rate-pressure product at rest and at ischemic threshold. None of the characteristics of anginal symptoms or exercise test results predicted a greater efficacy of nifedipine over metoprolol. CONCLUSIONS The results of a baseline exercise test, but not the characteristics of anginal symptoms, may offer useful information for selecting medical treatment in stable angina pectoris.

UI MeSH Term Description Entries
D008297 Male Males
D008790 Metoprolol A selective adrenergic beta-1 blocking agent that is commonly used to treat ANGINA PECTORIS; HYPERTENSION; and CARDIAC ARRHYTHMIAS. Beloc-Duriles,Betaloc,Betaloc-Astra,Betalok,CGP-2175,H 93-26,Lopressor,Metoprolol CR-XL,Metoprolol Succinate,Metoprolol Tartrate,Seloken,Spesicor,Spesikor,Toprol,Toprol-XL,Beloc Duriles,Betaloc Astra,CGP 2175,CGP2175,H 93 26,H 9326,Metoprolol CR XL,Toprol XL
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D009543 Nifedipine A potent vasodilator agent with calcium antagonistic action. It is a useful anti-anginal agent that also lowers blood pressure. Adalat,BAY-a-1040,Bay-1040,Cordipin,Cordipine,Corinfar,Fenigidin,Korinfar,Nifangin,Nifedipine Monohydrochloride,Nifedipine-GTIS,Procardia,Procardia XL,Vascard,BAY a 1040,BAYa1040,Bay 1040,Bay1040,Monohydrochloride, Nifedipine,Nifedipine GTIS
D011237 Predictive Value of Tests In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test. Negative Predictive Value,Positive Predictive Value,Predictive Value Of Test,Predictive Values Of Tests,Negative Predictive Values,Positive Predictive Values,Predictive Value, Negative,Predictive Value, Positive
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D003692 Delayed-Action Preparations Dosage forms of a drug that act over a period of time by controlled-release processes or technology. Controlled Release Formulation,Controlled-Release Formulation,Controlled-Release Preparation,Delayed-Action Preparation,Depot Preparation,Depot Preparations,Extended Release Formulation,Extended Release Preparation,Prolonged-Action Preparation,Prolonged-Action Preparations,Sustained Release Formulation,Sustained-Release Preparation,Sustained-Release Preparations,Timed-Release Preparation,Timed-Release Preparations,Controlled-Release Formulations,Controlled-Release Preparations,Extended Release Formulations,Extended Release Preparations,Slow Release Formulation,Sustained Release Formulations,Controlled Release Formulations,Controlled Release Preparation,Controlled Release Preparations,Delayed Action Preparation,Delayed Action Preparations,Formulation, Controlled Release,Formulations, Controlled Release,Prolonged Action Preparation,Release Formulation, Controlled,Release Formulations, Controlled,Sustained Release Preparation,Timed Release Preparation,Timed Release Preparations
D004311 Double-Blind Method A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment. Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D004562 Electrocardiography Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY. 12-Lead ECG,12-Lead EKG,12-Lead Electrocardiography,Cardiography,ECG,EKG,Electrocardiogram,Electrocardiograph,12 Lead ECG,12 Lead EKG,12 Lead Electrocardiography,12-Lead ECGs,12-Lead EKGs,12-Lead Electrocardiographies,Cardiographies,ECG, 12-Lead,EKG, 12-Lead,Electrocardiograms,Electrocardiographies, 12-Lead,Electrocardiographs,Electrocardiography, 12-Lead

Related Publications

D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
February 1996, Journal of the American College of Cardiology,
D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
June 1992, Journal of cardiovascular pharmacology,
D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
January 2013, Current pharmaceutical design,
D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
February 1990, Mayo Clinic proceedings,
D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
November 1995, La Revue du praticien,
D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
January 1980, Transactions of the Association of Life Insurance Medical Directors of America,
D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
November 1984, Australian family physician,
D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
April 1987, Comprehensive therapy,
D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
February 1991, Cardiology clinics,
D Ardissino, and S Savonitto, and K Egstrup, and K Rasmussen, and E A Bae, and T Omland, and P M Schjelderup-Mathiesen, and P Marraccini, and P A Merlini, and I Wahlqvist
September 2007, Nihon rinsho. Japanese journal of clinical medicine,
Copied contents to your clipboard!