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PubMed · 17153155

'The heart less bounding': treating angina pectoris.

A R Butler
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Abstract

Although one group of drugs (including amyl nitrite and glyceryl tinitrate) has been used in the treatment of angina for over 100 years, the mode of action became clear only after the endothelium-derived relaxing factor had been identified as nitric oxide in 1987. Originally sodium nitrite was included in this group of drugs but it rapidly fell out of favour. Recently, however, interest in its therapeutic use has been revived. The medical uses of saltpetre (potassium nitrate) may be due to the presence of nitrite as an impurity.

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Angina PectorisHistory, 19th CenturyHistory, 20th CenturyHumansNitratesNitritesVasodilator AgentsHistorical ArticleJournal Article

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A R Butler. 2006. 'The heart less bounding': treating angina pectoris.. https://pubmed.ncbi.nlm.nih.gov/17153155/

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PubMed2007

Effect of a hypoglycemic agent on ischemic preconditioning in patients with type 2 diabetes and stable angina pectoris.

OBJECTIVE: Ischemic preconditioning is an increased tolerance to myocardial ischemia during the second of two consecutive exercise tests. ATP-sensitive K(+) channel blockers, such as glinides and sulfonylurea drugs, can induce loss of ischemic preconditioning. This study aimed to investigate the effects of repaglinide, a hypoglycemic agent with an affinity for myocardial ATP-sensitive K (+)channels, on the results of consecutive exercise tests in patients with diabetes and multivessel coronary artery disease. METHODS: Forty-two patients with type 2 diabetes and chronic stable angina pectoris, and two-vessel or three-vessel disease participated in this study. The patients underwent two consecutive treadmill exercise tests (phase 1). On the day after these exercise tests, 2 mg of oral repaglinide was given to the patients. One week later, two exercise tests were repeated consecutively (phase 2). RESULTS: All patients achieved 1.0-mm ST-segment depression during the four exercise tests (T1, T2, T3, and T4). In phase 2, seven patients improved in time to onset of 1.0-mm ST-segment depression. The worsening of the time to onset of 1.0-mm ST-segment depression in phase 2 demonstrated ischemic preconditioning block in 83.3% of patients (P=0.0001). Even the postexercise electrocardiographic parameters (ST-segment depression morphology and magnitude and arrhythmias) were significantly different between the groups with and without pharmacologic ischemic preconditioning block (P=0.031). CONCLUSIONS: Repaglinide, an oral hypoglycemic agent with ATP-sensitive K(+) channel-blocker activity, eliminated the myocardial ischemic preconditioning in patients with coronary disease and diabetes.

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