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  • Title: [Tolerance to nitrates in patients with angina and effect of plasmapheresis].
    Author: Koziolova NA.
    Journal: Ter Arkh; 2001; 73(12):21-5. PubMed ID: 11858102.
    Abstract:
    AIM: To evaluate tolerance to isosorbide dinitrate (ID) in patients with angina pectoris functional class II-III and effect of plasmapheresis in this tolerance management. MATERIAL AND METHODS: 85 patients with angina pectoris functional class II-III taking long-acting ID. RESULTS: As shown by repeat transesophageal left atrial pacing, 24.7% patients have developed tolerance to nitrate while taking prolonged ID. Two methods of this tolerance elimination were compared: plasmapheresis + withdrawal of long-acting nitrate and withdrawal of the nitrates only. The former has shown some advantages: use of plasmapheresis reestablished ID efficiency in 4 days (two sessions) in 81.8% and in 7 days (3 sessions) in 100% patients without withdrawal syndrome. The latter method reestablished a marked antiischemic effect of ID in 7 days and 20% patients exhibited a variant of withdrawal syndrome--early negative aftereffect. CONCLUSION: When withdrawal of long-acting nitrates is combined with plasmapheresis in anginal patients to eliminate tolerance to nitrates, the effect is better.
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