Curative effect of diltiazem on non-ST-segment elevation acute coronary syndrome and refractory myocardial ischemia

LIU Xian-wen; XU Jing; TANG Xue-liang; ZHANG Di

doi:10.3969/j.issn.1674-4055.2017.04.20

Abstract：Objective To study the clinical efficacy of diltiazem on non-ST-segment elevation acute coronary syndrome and refractory myocardial ischemia (NSTEACS-RMI).Methods The patients with NSTEACS-RMI (n=124) were chosen from the Department of Internal Medicine, Second People's Hospital of Panyu District in Guangzhou from the Jan. 2012 to Dec. 2015, and then divided randomly into diltiazem group (n=64) and control group (n=60). The control group was treated with routine drugs including aspirin, low molecular weight heparin (LMWH), clopidogrel, angiotensin converting enzyme inhibitor (ACEI), metoprolol and statins, and diltiazem group, additionally with diltiazem (10 mg). The indexes of blood pressure (BP), heart rate (HR), frequency and duration of chest pain and extent of myocardial ischemia were observed, changes of NST, ∑ST and heart rate variability (HRV) were detected, and adverse reactions including conduction block, bradyarrhythmia, heart failure and arrhythmias were recorded, and clinical efficacy was reviewed in 2 groups after treatment for 7 d.Results After treatment, BP, HR, frequency and duration of chest pain, times of taking nitroglycerin, NST and ∑ST were all lower in diltiazem group than those in control group (all P<0.05). The all indexes of HRV were ameliorated significantly in diltiazem group compared with control group after treatment (allP<0.05). The total effective rate was 90.63% in diltiazem group and 61.67% in control group (P<0.05). The incidence of adverse reactions was 6.25% in diltiazem group and 1.56% in control group (P>0.05).Conclusion Diltiazem can significantly relieve myocardial ischemia and clinical symptoms with lower incidence of adverse reactions in patients with NSTEACS-RMI, and it is worth clinical application.