The effects of oral isosorbide 5-mononitrate on mortality following acute myocardial infarction: a multicentre study.

Abstract:

:We have conducted a randomized, double-blind, placebo-controlled multicentre trial of oral isosorbide 5-mononitrate (ISMN) in 360 patients with suspected acute myocardial infarction. Patients were stratified prior to analysis according to the presence or absence of left ventricular failure on admission. ISMN caused a significant reduction in systolic and diastolic blood pressure during the first 12 h. There was no significant effect on heart rate. Overall mortality was 4.9% in the ISMN group compared with 4.0% in controls at 5 days, and 14.1% compared with 10.5% at 6 months (NS). A non-significant reduction in mortality in the ISMN group with heart failure (ISMN 7.9%, placebo 12.9%, at 5 days) contrasted with a non-significant increase in mortality in patients without heart failure treated with ISMN (ISMN 4.1%, placebo 2.1%, at 5 days). Lignocaine was used in twice as many patients in the ISMN group as in placebo group (P less than 0.01), both with and without heart failure. Diamorphine usage was similar in the ISMN and control groups. Oral ISMN has similar haemodynamic effects to intravenous nitroglycerin, and can be of benefit in acute myocardial infarction with heart failure. However, our results question the use of nitrates in acute myocardial infarction in the absence of heart failure.

journal_name

Eur Heart J

journal_title

European heart journal

authors

Fitzgerald LJ,Bennett ED

doi

10.1093/oxfordjournals.eurheartj.a059667

subject

Has Abstract

pub_date

1990-02-01 00:00:00

pages

120-6

issue

2

eissn

0195-668X

issn

1522-9645

journal_volume

11

pub_type

临床试验,杂志文章,多中心研究,随机对照试验
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