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Nitrate Therapy for Angina PectorisCurrent Concepts About Mechanism of Action and Evaluation of Currently Available Preparations
Steven Corwin, MD;
James A. Reiffel, MD
Arch Intern Med. 1985;145(3):538-543.
Abstract
• Nitrates are presently used in the therapy for angina pectoris. They have both direct coronary vascular and indirect systemic effects; each appears to contribute to their antianginal efficacy. The various nitrate preparations, including the newer preparations recently made clinically available, have varying utilities in the relief of acute ischemic pain or for anginal prophylaxis. Nitrate tolerance and dependence are proved phenomena, yet their impact on the clinical usage of nitrates is not clearly defined. The utility of nitrates, including intravenous nitroglycerin, in the treatment of unstable angina and vasospastic angina is well documented. Their efficacy compared with that of calcium channel blockers is still being investigated. The reported adverse effects of nitrates are few, despite their many years of usage in clinical medicine.
(Arch Intern Med 1985;145:538-543)
Author Affiliations
From the Department of Medicine, Columbia University College of Physicians and Surgeons and The Presbyterian Hospital, New York.
Footnotes
Accepted for publication Sept 25, 1984.
Reprint requests to Columbia Presbyterian Medical Center, 161 Fort Washington Ave, New York, NY 10032 (Dr Reiffel).
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