Short- and long-term efficacy of high-dose oral diltiazem for angina due to coronary artery disease: A placebo-controlled, randomized, double-blind crossover study

Abstract

The effects of oral diltiazem (360 mg/day) on exercise tolerance, left ventricular performance, and plasma lactate and catecholamine levels were studied in 13 patients with atherosclerotic coronary artery disease in a placebo-controlled, randomized, double-blind protocol. Exercise duration to the onset of ischemic ST segment depression, time to angina pectoris, and time to peak exercise improved by 120, 174, and 144 sec, respectively (p < .0001). Left ventricular ejection fraction, as determined by radionuclide angiography, increased in patients at rest from 52 ± 11% (mean ± SD) during placebo therapy to 58 ± 11% during diltiazem therapy (p < .001); at peak exercise ejection fraction increased from 44 ± 11% during placebo treatment to 52 ± 15% during diltiazem therapy (p