EFFECT OF ORAL PENTOXIFYLLINE IN EXERCISE-INDUCED SILENT-MYOCARDIAL-ISCHEMIA

Pentoxifylline, a methyl xanthine derivative with hemorheologic properties, has been used in the treatment of peripheral and cerebrovascular occlusive diseases. To assess its effect in myocardial ischemia, 20 patients with previous myocardial infarction and silent ischemia at exercise were randomized to receive pentoxifylline 1.2 gm/day or placebo during a 3-month double-blind trial. There were no differences in age, body mass index, or risk factors between groups. At the end of the study, patients in the placebo group showed no changes in physical work capacity or ST segment depression. In contrast, patients in the pentoxifylline group showed a slight but significant increase in physical work capacity (+0.24 +/- 0.07 watts/kg; P < 0.01) and a decrease in both maximal exercise-induced ST segment depression (-0.80 +/- 0.18 mm; P < 0.01) and at the ninth minute of recovery (-0.38 +/- 0.13 mm; P < 0.05). The drug was generally well tolerated. We conclude that pentoxifylline diminishes exercise- induced electrocardiographic changes of myocardial ischemia and improves physical work capacity.