Various mononitrate forms in the treatment of patients with effort angina

Aim. Clinical and device evaluation of efficacy of new dosage forms of isosorbide-5-mononitrate (ISMN) in patients with angina of effort of functional class (FC) II-III in 1-3 month treatment. Material and methods. 54 patients with ischemic heart disease (IHD) and stable angina pectoris (42 males, 12 females aged 48-70, mean age 59.4 ± 3.6 years) were examined. 16 of them had angina of effort FC II, 35 - of FC III and 3 - of FC IV. IHD was verified at stress tests and 24-h Holier ECG monitoring. In 85.2% of IHD patients the diagnosis of stenotic coronary atherosclerosis of 1-3 great arteries was confirmed by coronarography findings. The treatment effect was assessed by bicycle exercise tests, Hotter ECG monitoring, patients' records of anginal attacks before and after treatment. Results. Long-term forms of ISMN - Mono Mac Depo (100 mg) and Mono Mac 50D (50 mg) - and non-retard form Mono Mac (40 mg) produced a stable antianginal effect in 85, 80 and 75% patients, respectively. ISMN preparations given for 1 and 3 months reduced frequency of anginal attacks, improved functional condition of the patients, exercise tolerance, variability of heart rhythm. Mono Mac Depo and Mono Mac 50 D were well tolerated, induced no serious side effects. Conclusion. ISMN preparations can be recommended as monotherapy in patients of FC II-III angina or in combination with beta adrenoblockers for treatment of patients with angina FC III-IV.