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Silber S, Tourlakidou S, Stoeter M, Stalleicken D, Schneider HT:
The PETN-Study (Pentaerythrityltetranitrate Evaluation of Tolerance Development with Nitrates): a double-blind, placebo-controlled comparison of two different dosages.
Perfusion, 17: 236-244, 2004
The medical treatment of coronary artery disease with organic nitrates aims tosubstitute endothelial derived relaxing factor (EDRF = NO). Most nitrates, however, induce rapidly nitrate tolerance, depending on dosing and formulation. PETN has first been used medically in 1943 and was the only long-acting nitrate available in former East-Germany. In the present study, the efficacy of
150 mg PETN per day either once daily or administered in three doses for 14 days was evaluated. 95 patients with proven or a high likelyhood of CAD were enrolled in this double-blind, placebo-controlled study.
On the 1st treatment day, 150 mg o.d. increased the exercise duration as compared to baseline from 300.5±99.43 s by 60.3±56.1 s. After 50 mg t.i.d., the increase was 69.4±67.2 s (baseline: 299.5±102.6 s) and after placebo 60.7±55,7 s (baseline: 310.9± 78.6 s). On the 14th treatment day, the increase over the baseline measurements was 93.9±110.8 s (1 x 150mg), 102.6±83.0 s (3 x 50 mg) and 85.0±60.2 s (placebo), respectively. Hence, the superiority of an administration of 50 mg PETN t.i.d. over the placebo effect was demonstrated to be more pronounced than the administration of 150 mg o.d. Therefore, the administration of PETN 50 mg t.i.d. should be preferred over 150 mg once daily.
Keywords: PETN, pentaerythrityltetranitrate, dosage, nitrate tolerance, coronary
artery disease, exercise duration