Open AccessTime sequence of anginal pain
Author(s) -
Mattioli G.,
Cioni G.,
Andreoli C.
Publication year - 1986
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960090407
Subject(s) - medicine , isosorbide dinitrate , chest pain , metoprolol , placebo , angina , cardiology , coronary arteries , nifedipine , circadian rhythm , coronary artery disease , stenosis , anesthesia , artery , myocardial infarction , calcium , alternative medicine , pathology
We studied 187 patients with angina at rest in order to evaluate the circadian rhythm of chest pain attacks. All subjects were followed for 7 days in absence of therapy (placebo period) and then with therapy (nifedipine, metoprolol, or isosorbide dinitrate). During the placebo period (1309 days) 1466 attacks were recorded, on an average of 1.1 per day. Most episodes occurred between 5 and 8 A.M. The incidence of chest pain attacks was much lower between 9 A.M. and 4 P.M. During the period with therapy, a reduction of painful episodes was observed, while the diurnal distribution remained unchanged. Furthermore, we studied the relationship between circadian distribution of anginal attacks and the extension of coronary damage in the 76 patients who underwent coronary angiography. Alterations of diurnal distribution of chest pain attacks were noted in subjects with normal coronary arteries and those with one‐vessel and two‐vessel disease. Patients with three‐vessel disease or left main coronary artery stenosis showed more uniform distribution of their attacks.