Propranolol and Practolol in the Treatment of Spontaneous Angina Pectoris

概要

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In a comparative trial practolol was found to be quite superior to propranolol in the treatment of spontaneous angina pectoris. Propranolol did not reduce the number of anginal attacks in the 24 hours, as evaluated through the patients' charting and continuous electrocardiographic recording, and induced exaggerated bradycardia as well as clinical and hemodynamic signs of poor cardiac performance. In the same patients practolol achieved complete disappearance of the anginal attacks, and returned cardiac function to quite satisfactory levels. The forcedly low doses might be one of the possible reasons of the failure of propranolol.The attacks of the angina here investigated occurred at rest and in absence of any detectable eliciting factor. They were not triggered by circulatory modifications interfering with the oxygen requirement of the heart. These findings make the favorable therapeutic response to betablockade of difficult interpretation on the basis of the mechanisms usually indicated for the antianginal action of these drugs, and suggest that some other, still unknown effect must be at work.
International Heart Journal刊行会の論文