Comparative Clinical Trial of Oxyfedrine And Oxprenolol In Patients With Angina Pectoris

Abstract

Oxyfedrine, a new anti-anginal drug with a unique mode of action, was compared with placebo and oxprenolol in thirty patients with stable angina pectoris. Total exercise time and exercise time to onset of angina was significantly improved, compared to placebo and was comp arable to that produced by oxprenolol. Heart rate and blood pressure were not affected. Side effects were few.
INTRODUCTION:
Over the past decade much advance has been made in the treatment of angina pectoris. Although coronary artery bypass surgery is the therapy of choice in certain sub-groups of patients with angina, in the vast majority medical therapy is used initially and surgery resorted to only in those cases where full medical therapy has failed to control disabling symptoms of angina.

MATERIAL AND METHODS:
Thirty consecutive patients with stable angina pectoris seen in the Cardiology Clinic were enrolled into the trial. The patients gave written consent and the Hospital Ethics Committee approved the protocol. All the patients had typical symptoms of effort induced angina, had normal resting electrocardiograms and had evidence of cardiac ischemia on exercise. Apart from nitrates they had not received any other anti-anginal therapy.

RESULTS:

Thirty patients entered the trial nineteen males and eleven females). Their mean age was 52.3 years (range 37 65), mean weight was 74.3 kg (range 51-104), mean height’ was 169.1 cm (range 150-187) and mean body surface area was 1.83m² (range 1.57-2.10). Of these, five patients(three males and two females), failed to complete the trial.

DISCUSSION:
The therapy of angina pectoris in the first instance is medical. Coronary angiography, in this country, is performed only when full medical therapy has failed and the decision has been made to proceed to either coronary artery bypass grafting or coronary angioplasty. It is possible that this practice may change in future, if it is proven that surgical therapy is superior to medical therapy in the prognosis of coronary artery disease.

In summary oxyfedrine is a new anti-anginal drug with a unique mode of action, different from that of other anti-anginal drugs, is as effective as oxprenolol in the treatment of angina, is well tolerated and has few side effects. It provides a viable alternative to existing forms of antia nginal therapy and may even be used as a first line drug in the management of angina.
ACKNOWLEDGEMENTS :
We thank ASTA Pharma AG of Frankfurt for supplies of tablets and placebo, Dr. R. Kohn and Dr. J. Whittington of Medical Advisory Services (Clinical and General) Limited for organis ational assistance and Mrs. J. M. Dalton for secretarial services.