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57 patients were admitted to the study, 3-6 weeks after acute myocardial infarction. They received either placebo or 1 mg/kg tiapamil intravenously according to a randomized, double-blind procedure. The study had two objectives: (a) to assess the effect of tiapamil on work tolerance and exercise-induced myocardial ischemia; (b) to demonstrate possible antiarrhythmic effects against exercise-induced arrhythmias. The duration of exercise and physical work capacity increased slightly in both groups, these effects, however, not reaching statistical significance. On the other hand, the number of exercise-induced extrasystoles did not change significantly under placebo but decreased from 30.9 to 14.8 beats/min after tiapamil (p < 0.01). No side effects were observed. While the hemodynamic effects of tiapamil in patients with coronary artery disease are yet to be elucidated, our findings confirm the efficacy of this calcium antagonist against exercise-induced ventricular premature beats in patients with coronary artery disease.

The effectiveness of iloprost, a prostacyclin derivative, was assessed in a placebo-controlled multicentre trial on 101 patients with chronic arterial disease, stage IV. All patients were on a basic local treatment, 53 randomly being assigned to the iloprost group, 48 to the placebo one. Both groups received identical saline infusions, one with the other without iloprost. Infusions were given on 28 consecutive days, iloprost being added at a dose of up to 2 ng/kg.min over six hours. At the end of the treatment period, 32 of 52 patients (61.5%) of the iloprost group and eight of the 47 in the placebo group (17%) had partial or complete healing of ulcers (P less than 0.05), the treatment effect persisting in both groups for a mean duration of at least one year. Iloprost was well tolerated, once individual dosages had been appropriately adjusted. Facial flushes, headache and nausea were the most common side effects. Heart rate and blood-pressure variations did not differ between the two groups.

26 patients who had undergone right heart catheterization were enrolled in the study. The average age was 51.7 ± 15 years. Half the patients showed coronary artery disease at selective coronary angiography. His bundle recordings and atrial pacing were performed before and 10 min after 1 or 1.5 mg/kg i.v. tiapamil. In addition, arterial blood pressure was recorded. P-R interval increased from a mean value of 153 ± 36 to 168 ± 49 ms (p < 0.05) due to an increase in the A-H time from 88 ± 19 to 97 ± 23 ms (p < 0.05). Arterial blood pressure and heart rate decreased significantly. These changes were more pronounced in patients with coronary artery disease. In the groups with the higher dosage, the differences from the control values were greater than in the patient groups receiving 1.0 mg/kg. Sinus node recovery time tended to increase in all groups but the differences did not reach significance. Patients with the ‘sick sinus syndrome’ were not studied.

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