Prognosis of silent myocardial ischemia and its strategy for treatment.

chest pain group. 3) Effective treatment: The efficacy of three standard antianginal drugs on silent myocardial ischemia was studied in 43 patients with EA using Holter monitoring. Antianginal drugs used were long-acting isosorbide dinitrate 40-80 mg/day for nitrates (17 patients), diltiazem 90-180 mg/day for calcium antagonists (13 patients), propranolol 30-60 mg/day or metoprolol 60-120 mg/day for /S -blocker (13 patients). The severity of ischemia (total magnitude and duration of ST deviation) was improved with all three drugs. However, with respect to the frequency of ischemic episodes, nitrates and calcium antagonists did not reduce asymptomatic episodes in the daytime, while /3 -blockers signif-