Efficacy of denopamine, a β1 Adrenoceptor agonist, in preventing coronary artery spasm.

Abstract

The selective β1 adrenoceptor agonist denopamine was studied for its effectiveness in abolishing active vasospastic angina in 10 patients without obstructive coronary artery stenosis. All patients had anginal attacks at least once a day during the 3-day placebo period. Denopamine, 40 mg/day, completely abolished the attacks in 7 patients (efficacy 70%). Denopamine reduced the mean daily number of anginal attacks and nitroglycerin consumption in comparison with placebo (0.56±1.23 vs 2.20±1.27; p<0.005 and 0.10±0.24 vs 1.60±1.93; p<0.05, respectively). Aggravation of anginal attacks was not seen in any patient. During placebo period, anginal attacks were provoked in 6 of the 10 patients who recieved exercise stress test, and in 6 of the 7 patients who recieved the cold pressor test in combination with hyperventilation. Denopamine pre-vented anginal attacks induced by exercise stress tests in 4 of the 6 patients (67%) and that induced by the cold pressor test in 4 of the 6 patients (67%). There were no severe adverse effects during denopamine therapy. These results suggest that 1) denopamine is a safe and effective medication for vasospastic angina; 2)β1 adrenoceptors may play an important role in the prevention of coronary artery spasm. © 1993, The Japanese Circulation Society. All rights reserved.