+1 Recommend
1 collections
      • Record: found
      • Abstract: found
      • Article: found

      Rationale and Design of GISSI 3


      S. Karger AG

      Myocardial infarction, Combined end points, Angiotensin-converting enzyme inhibitor, Nitrates, Thrombolytics

      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.


          GISSI 3 is an open randomized population trial to assess the comparative value of two different therapeutic strategies based on nitrates and angiotensin-converting enzyme inhibition respectively versus routine treatment in improving the short- and long-term outcome of patients with acute myocardial infarction. Methodologically the protocol of this trial may be seen from two complementary points of view: (1) as the natural continuation of a successful formula (inclusion of the large majority of Italian coronary care units) which has proven capable of producing interesting experimental results with direct epidemiological and public health implications and (2) as the evolution of a strategy which was restricted mainly to coronary care units to include intensive posthospital surveillance of the recruited patients whose outcome is measured on the basis of the combined end point of mortality and severe left-ventricular damage. The pharmacological and clinical interests of comparing the effects of a nitrate-based approach (predominantly vasodilation) and a multitargeted one based on angiotensin-converting enzyme inhibition (lisinopril is the study drug) need not be emphasized. The pilot study is now completed and the main trial will commence in summer 1991 recruiting 20,000 patients with acute myocardial infarction who will be randomized within 24 h after onset of pain and followed up for 12 months. The main study will follow a 2 × 2 factorial design with four treatment groups: lisinopril alone nitrates alone combined therapy and no trial therapy.

          Related collections

          Author and article information

          S. Karger AG
          12 November 2008
          : 79
          : Suppl 1
          : 74
          Istitute Mario Negri, Milan, Italy
          174909 Cardiology 1991;79:74
          © 1991 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          Page count
          Pages: 1
          Session II – Future Perspective


          Comment on this article