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      Comparative Evaluation of Intravenous Isosorbide Dinitrate and Nitroglycerin in Patients with Acute Myocardial Infarction

      , , ,

      Cardiology

      S. Karger AG

      Isosorbide dinitrate, Nitroglycerin, Myocardial infarction

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          Abstract

          The efficacy of isosorbide dinitrate (ISDN) and nitroglycerin was studied in 115 patients with acute transmural myocardial infarction admitted to the Coronary Care Unit not later than 12 h after the onset of chest pain: 58 patients not later than 2 h after the onset of chest pain, 49 after 3–6 h and 8 patients in the period of 6–9 h. There were 69 men and 45 women, mean age 62.4 ± 0.9 years. The duration of the preceding clinically evident coronary artery disease was in 12 patients 1 year, in 29 2–3, in 22 4–5 and in 16 patients 6 years or more. In 36 cases the chest pain of acute infarction was the first presentation of coronary artery disease. Thirty-seven patients had a previous myocardial infarction. Fifty patients had concomitant systemic hypertension. The patients were divided into 3 groups depending on the type of therapy received: group I, receiving anticoagulants only, served as control; patients of groups II and III received, in addition to the anticoagulants, intravenous ISDN or nitroglycerin, respectively. The patients were monitored for recurrent chest pain, electrocardiographic changes, clinical parameters and cardiac enzyme changes. ISDN, at a dose of 10 mg/h over the first 3 days of infarction, had marked antianginal effect, limited the dimensions of the necrotic area, reduced the number of ischemic relapses and the development of heart failure. Compared to nitroglycerin, ISDN exerted a more prolonged action (up to 12 h), did not affect heart rate and blood pressure, and had a marked antiarrhythmic effect. This last finding widens the indications for the use of ISDN in patients with myocardial infarction.

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          Author and article information

          Journal
          CRD
          Cardiology
          10.1159/issn.0008-6312
          Cardiology
          S. Karger AG
          978-3-8055-5486-2
          978-3-318-01618-5
          0008-6312
          1421-9751
          1991
          1991
          12 November 2008
          : 79
          : Suppl 2
          : 63-69
          Affiliations
          III Moscov Stomatological Institute after Semashko, Moscou, USSR
          Article
          174927 Cardiology 1991;79:63–69
          10.1159/000174927
          1760833
          © 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.

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          Pages: 7
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