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      Chronic Use of Continuous Dosing of Long-Term Nitrates Does Not Prevent Cardiac Events in Patients with Severe Acute Myocardial Infarction


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          This study was performed to investigate the effects of the chronic use of continuous, not eccentric, dosing of nitrates on cardiac events in patients with severe acute myocardial infarction. A total of 1,303 patients with healed myocardial infarction were divided into two groups: treatment with nitrates or nontreatment. Primary end points were nonfatal and fatal recurrent myocardial infarction, death from congestive heart failure and sudden death. Among the 725 patients treated with nitrates, 45 patients (6.2%) experienced cardiac events during the observation period, whereas only 17 of the 578 patients treated without nitrates (2.9%) had cardiac events. This difference was statistically significant (p < 0.01; odds ratio 2.18, 95% confidence interval 1.24–3.86). In Killip class II–IV patients, the incidence of cardiac events in patients with nitrates was significantly greater than in patients without nitrates (18.8 vs. 3.5%, p < 0.05). The chronic use of continuous, not eccentric, dosing of nitrates did not prevent cardiac events in patients with severe acute myocardial infarction.

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          ISIS-4: A randomised factorial trial assessing early oral captopril, oral mononitrate, and intravenous magnesium sulphate in 58 050 patients with suspected acute myocardial infarction

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            GISSI-3: effects of lisiriopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction

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              Long-Term Nitrate Treatment Increases Cardiac Events in Patients With Healed Myocardial Infarction


                Author and article information

                S. Karger AG
                February 2001
                02 March 2001
                : 94
                : 3
                : 139-145
                The First Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan
                47308 Cardiology 2000;94:139–145
                © 2001 S. Karger AG, Basel

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                Page count
                Figures: 1, Tables: 3, References: 30, Pages: 7
                General Cardiology


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