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We investigated wether combined i.v.infusion of nitrates and heparin (H) may produce H resistance. Twenty stable pts. (2f, 18m; age:47-80) with proven coronary artery disease having been on a constant H infusion for at least 4 days were enrolled in the study. H was given by an infusion pump and titrated to achieve activated partial thromboplastin times (PTT) of > 60 sec. On study days 1 and 2 all nitrates were withdrawn and on day 1 H dose was optimized and fixed (mean H dose 33.600 U/24h). On day 2 all pts. received i.v. saline (0,9% NaCI; 3 ml/h) by means of a second infusion pump. On day 3 saline was randomly (single blinded) replaced for 24 h by either nitroglycerin (NTG,O,I% saline-solved; dose 3-5 mg/h) or isosorbidedinitrate (ISDN, 0,1% salinesolved; 4-6 mg/h). There was no difference in the anticoaqulatory effect of H during i.v.saline and either i.v.NTG or i.v. ISDN, as jugded by comparison of the area under the PTT curve on days 2 and 3 (PTT done at 8,10,13,15,18,. Mean H doses were equal in the NTG and ISDN groups.Furthermore, when nitrates were stopped on day 4 no changes in PTT could be observed for up to 6 hours. In conclusion, neither NTG nor ISDN influence the antieoagulatory effect of H during concomitant i.v.-infusion over 24h.
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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 p