Table 19.7CCBs vs. nitrates for Cardiac Syndrome X

Quality assessmentSummary of findings
No of patientsEffectQuality
No of studiesDesignLimitationsInconsistencyIndirectnessImprecisionOther considerationsCCBsNitratesRelative (95% CI)Absolute
Number of anginal episodes (per 4 weeks per patient) - amlodipine vs. ISMN (follow-up 4 weeks; range of scores: -; better indicated by less)
Lanza 1999231(c)randomised trial (a)serious (b)no serious inconsistencyno serious indirectnessserious imprecision (d)none1010-MD 2 lower (21.28 lower to 17.28 higher)⊕⊕○○

LOW
Chest pain episodes duration (min) - amlodipine vs. ISMN (follow-up 4 weeks; range of scores: -; better indicated by less)
Lanza 1999231(c)randomised trial(a)serious (b)no serious inconsistencyno serious indirectnessno serious imprecisionnone1010-MD 5 higher (6.39 lower to 16.39 higher)⊕⊕○○

LOW
severity of chest pain (scale 1–5) - amlodipine vs. ISMN (follow-up 4 weeks; range of scores: -; better indicated by less)
Lanza 1999231(c)randomised trial (a)serious (b)no serious inconsistencyno serious indirectnessno serious imprecisionnone1010-MD 0.4 higher (0.57 lower to 1.37 higher)⊕⊕○○

LOW
quality of life (scale 0–100 mm) - amlodipine vs. ISMN (follow-up 4 weeks; range of scores: -; better indicated by less)
Lanza 1999231(c)randomised trial (a)serious (b)no serious inconsistencyno serious indirectnessno serious imprecisionnone1010-MD 21 higher (1.81 lower to 43.81 higher)⊕⊕○○

LOW
a
b

Lanza 1999[225]: Randomisation and allocation concealment unclear, small sample size

c

Amlodipine 10mg/day, ISMN 50mg/day

d

95% CI includes no effect and the upper and lower CI crosses the MID.

From: 19, Cardiac syndrome X

Cover of Stable Angina
Stable Angina: Methods, Evidence & Guidance [Internet].
NICE Clinical Guidelines, No. 126.
National Clinical Guidelines Centre (UK).
Copyright © 2011, National Clinical Guidelines Centre.

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