Diltiazem Has Its Limits in Angina with Nonobstructive Coronary Disease

The drug reduced the rate of epicardial spasm, but not microvascular dysfunction or angina symptoms.

Diltiazem is frequently prescribed for patients with angina and nonobstructive coronary artery disease (ANOCA) because coronary dysfunction is presumed to be the mechanism. However, evidence of diltiazem's benefit in this population is sparse, prompting investigators to enroll 126 patients with ANOCA in an industry-funded study of diltiazem's effect on coronary dysfunction, defined as the presence of vasospasm (after intracoronary acetylcholine provocation), microvascular dysfunction (coronary flow reserve <2.0, index of microvascular resistance ≥25), or both.

Of the 99 patients with confirmed dysfunction on coronary function testing (CFT), 85 were randomized to receive oral diltiazem (up to 360 mg/day) or placebo for 6 weeks. At 6-week foll…

Reviewing Author

Karol E. Watson, MD, PhD, FACC

Disclosures

Consultant/Advisory BoardBoehringer Ingelheim; Amgen; Novartis; Lilly; Amarin

Speaker’s BureauBoehringer Ingelheim

Grant/Research SupportNIH

Editorial BoardsCirculation (Associate Editor)