Addition of felodipine to metoprolol vs replacement of metoprolol by felodipine in patients with angina pectoris despite adequate beta-blockade. Results of the Felodipine ER and Metoprolol CR in Angina (FEMINA) Study. Working Group on Cardiovascular Resea

Abstract:

AIMS:The study aimed to compare the addition of felodipine to metoprolol, and of the replacement of metoprolol by felodipine, with continuation of metoprolol, in patients with angina pectoris despite optimal beta-blockade. METHODS AND RESULTS:The study was double-blind, parallel, randomized and controlled, and comprised 363 patients from 27 outpatient cardiology clinics in the Netherlands. The patients had angina and positive bicycle exercise tests despite optimal beta-blockade (resting heart rate < 65 beats.min-1). Randomization was to three treatment groups: continuation of metoprolol (control), addition of felodipine to metoprolol, and replacement of metoprolol by felodipine. Exercise tests were repeated after 2 and 5 weeks. The main outcome measure was: exercise result after 5 weeks, compared with baseline, between-group comparison of changes vs control. There were no significant differences in exercise duration and onset of chest pain vs control. The addition of felodipine increased time until 1 mm ST depression (43 s, 95% confidence interval 20-65 s), and decreased both ST depression at highest comparable work load (0.46 mm, 95% confidence interval 0.19-0.72), and maximal ST depression (0.49 mm, 95% confidence interval 0.23-0.74). Exercise results after replacement of metoprolol by felodipine were not different from control, apart from a significant increase in rate pressure product. Significantly more patients experienced adverse events in the felodipine monotherapy group. CONCLUSION:Combination of metoprolol and felodipine is to be preferred to felodipine monotherapy in patients who have signs and symptoms of myocardial ischaemia despite optimal beta-blockade.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Dunselman P,Liem AH,Verdel G,Kragten H,Bosma A,Bernink P

doi

10.1093/oxfordjournals.eurheartj.a015170

subject

Has Abstract

pub_date

1997-11-01 00:00:00

pages

1755-64

issue

11

eissn

0195-668X

issn

1522-9645

journal_volume

18

pub_type

临床试验,杂志文章,随机对照试验
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    authors: Esposito K,Giugliano D

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  • Experience of percutaneous transluminal coronary angioplasty in orthotopic cardiac transplant recipients.

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    更新日期:1991-11-01 00:00:00

  • Surgical treatment of active infective aortic valve endocarditis with associated periannular abscess--11 year results.

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    doi:10.1053/euhj.1999.1877

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    更新日期:2000-03-01 00:00:00

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    journal_title:European heart journal

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    doi:10.1093/eurheartj/ehi501

    authors: Lamblin N,Mouquet F,Hennache B,Dagorn J,Susen S,Bauters C,de Groote P

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    pub_type: 杂志文章

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    更新日期:1994-06-01 00:00:00

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    pub_type: 杂志文章

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    pub_type: 杂志文章

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    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehn167

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    更新日期:2008-06-01 00:00:00

  • Angina with normal coronary arteries: diagnosis, pathophysiology and treatment.

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    pub_type: 杂志文章,评审

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    更新日期:1996-12-01 00:00:00

  • Sustained-release diltiazem versus metoprolol in stable angina pectoris.

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    pub_type: 临床试验,杂志文章,随机对照试验

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    更新日期:1989-10-01 00:00:00

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    journal_title:European heart journal

    pub_type: 杂志文章,多中心研究,随机对照试验

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    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehaa138

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  • Risk indicators for death in patients treated for hypertension; emphasis on consequences for airline pilots.

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    pub_type: 杂志文章,评审

    doi:10.1093/eurheartj/5.suppl_a.33

    authors: Bulpitt CJ

    更新日期:1984-03-01 00:00:00

  • A randomized controlled trial of dapagliflozin on left ventricular hypertrophy in people with type two diabetes: the DAPA-LVH trial.

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    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehaa419

    authors: Brown AJM,Gandy S,McCrimmon R,Houston JG,Struthers AD,Lang CC

    更新日期:2020-09-21 00:00:00

  • Felodipine in chronic stable angina: a randomized, double-blind, placebo-controlled, crossover study.

    abstract::To investigate the antianginal efficacy and tolerability of felodipine, a new dihydropyridine calcium antagonist, 20 patients with stable exertional angina, not completely controlled by beta-blocker monotherapy, entered a randomized, double-blind, placebo-controlled, crossover study. Patients on standard beta-blocker ...

    journal_title:European heart journal

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/oxfordjournals.eurheartj.a059628

    authors: Sangiorgio P,Di Pasquale G,Savonitto S,Urbinati S,Rubboli A,Cavallotti G,Pinelli G,Bracchetti D

    更新日期:1990-11-01 00:00:00

  • Prognosis and treatment of atrial fibrillation patients by European cardiologists: one year follow-up of the EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase (EORP-AF Pilot registry).

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    journal_title:European heart journal

    pub_type: 杂志文章,多中心研究

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    pub_type: 杂志文章

    doi:10.1093/oxfordjournals.eurheartj.a014717

    authors: Behar S,Haim M,Hod H,Kornowski R,Reicher-Reiss H,Zion M,Kaplinsky E,Abinader E,Palant A,Kishon Y,Reisin L,Zahavi I,Goldbourt U

    更新日期:1996-10-01 00:00:00

  • Myocardial bridging of the left anterior descending coronary artery without relation to the site of hypertrophy in hypertrophic cardiomyopathy.

    abstract::Myocardial bridging of the left anterior descending coronary artery producing complete systolic occlusion was demonstrated in a patient with hypertrophic cardiomyopathy, who had localized myocardial hypertrophy in the lateral left ventricular wall outside the territory of that artery. Although a cause and effect relat...

    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/8.7.793

    authors: Doi YL,Yamada M,Hamashige N,Yonezawa Y,Odawara H,Ozawa T

    更新日期:1987-07-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehp260

    authors: Schoenhagen P,Tuzcu EM,Kapadia SR,Desai MY,Svensson LG

    更新日期:2009-09-01 00:00:00

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    pub_type: 杂志文章

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    更新日期:2001-06-01 00:00:00

  • Pyrimidine nucleotide metabolism in cardiac hypertrophy.

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    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/5.suppl_f.155

    authors: Rossi A,Aussedat J,Olivarès J,Ray A,Verdys M

    更新日期:1984-12-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1093/eurheartj/5.suppl_e.117

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    更新日期:1984-11-01 00:00:00

  • The value of exercise-induced U-wave inversion on ECG chest wall mapping in the identification of individual coronary arterial lesions.

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    journal_title:European heart journal

    pub_type: 杂志文章

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    更新日期:1995-10-01 00:00:00

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    doi:10.1093/eurheartj/10.suppl_d.29

    authors: Iliceto S,Izzi M,De Martino G,Rizzon P

    更新日期:1989-09-01 00:00:00

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    journal_title:European heart journal

    pub_type: 杂志文章

    doi:10.1093/eurheartj/ehq142

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