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The antiischemic effect of the once-daily administration of felodipine,a new long-acting vaso-selective calcium antagonist, given at a dose of 10 and 20 mg,was compared with that of nifedipine, given at the dose of 20 mg four times a day ,in a randomized double-blind study involving 30 consecutive patients with Prinzmetal's angina.Three patients dropped out, while 27 completed the study.The therapeutic regimens tested proved to be similarly effective: primary end-points,-ischemic episodes recorded on Holter monitoring and anginal attacks reported on diary cards-,occurreo in 5/27 patients (19%) during nifedipine treatment,7/27 (26%) and 3/27 (11%) during felodipine treatment with 10 mg and 20 mg respectively(p=NS).The distribution of residual ischemic episodes demonstrated that the once-daily treatment with felodipine ensures 24-hour antiischemic protection.Twentysix of the patients were followed up with felodipine 20 mg once daily for ~+5 months and 21(81%) of them remained free of symptoms and Holter-recorded ischemic attacks. We conclude that, in Prinzmetal's angina pectoris,24-hour antiischemic protection may be achieved with the oncedaily administration of felodipine as effectively as with nifedipine given four times a day.
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