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Titolo:
NITRATES IN MYOCARDIAL-INFARCTION - INFLUENCE ON INFARCT SIZE, REPERFUSION, AND VENTRICULAR REMODELING
Autore:
MORRIS JL; ZAMAN AG; SMYLLIE JH; COWAN JC;
Indirizzi:
GEN INFIRM,DEPT CARDIOL LEEDS LS1 3EX W YORKSHIRE ENGLAND GEN INFIRM,DEPT CARDIOL LEEDS LS1 3EX W YORKSHIRE ENGLAND
Titolo Testata:
British Heart Journal
fascicolo: 4, volume: 73, anno: 1995,
pagine: 310 - 319
SICI:
0007-0769(1995)73:4<310:NIM-IO>2.0.ZU;2-Y
Fonte:
ISI
Lingua:
ENG
Soggetto:
COLLATERAL BLOOD-FLOW; SEGMENT RECOVERY ANALYSIS; PLASMA ENZYME LEVELS; INTRAVENOUS NITROGLYCERIN; CORONARY-OCCLUSION; THROMBOLYTIC THERAPY; LATE POTENTIALS; HIGH-RESOLUTION; ARTERY PATENCY; TRIAL;
Keywords:
MYOCARDIAL INFARCTION; ISOSORBIDE DINITRATE; ISOSORBIDE MONONITRATE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
38
Recensione:
Indirizzi per estratti:
Citazione:
J.L. Morris et al., "NITRATES IN MYOCARDIAL-INFARCTION - INFLUENCE ON INFARCT SIZE, REPERFUSION, AND VENTRICULAR REMODELING", British Heart Journal, 73(4), 1995, pp. 310-319

Abstract

Objective-To assess the possible benefits of intravenous isosorbide dinitrate in acute myocardial infarction and oral isosorbide mononitrate in subacute myocardial infarction. Methods-316 patients presenting with acute myocardial infarction were entered into double blind placebocontrolled clinical trials assessing infarct size by enzyme release, ventricular size and function by echocardiography, reperfusion by continuous It lead ST segment monitoring and late potentials by high resolution electrocardiography. Results-301 patients, of whom 292 (97%) received thrombolytic treatment, were randomised on admission to intravenous isosorbide dinitrate or placebo. Overall, there was no significanteffect of treatment on infarct size, ST segment resolution, ventricular remodelling, or late potentials at day 3. A trend was observed towards a reduction in infarct size in patients with non-Q wave infarctiontreated with isosorbide dinitrate. Heterogeneity of nitrate effect was observed in relation to the degree of ST segment elevation on presentation with a clear benefit of isosorbide dinitrate in patients with moderate ST segment elevation (472 U/I v 704 U/l, P = 0.003) and a trend towards a deleterious effect in patients with marked ST segment elevation (1152 Un v 1058 Un, P = 0.2). ST segment re-elevation was more common among patients receiving nitrate treatment than in those assigned to placebo (29 v 16, P < 0.05). Some 160 patients underwent a further randomisation to sustained release isosorbide mononitrate or placeboon day 3. Echocardiographic volumes after 6 weeks of treatment were similar in the two groups. Conclusions-No benefit was observed with administration of nitrates in the treatment groups as a whole for either acute or subacute infarction. There was, however, evidence of heterogeneity of effect in the different subgroups of acute infarction, and the possibility that nitrates may have differing actions in different groups of patients should be considered.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/11/20 alle ore 14:30:43