Sulfinpyrazone in the prevention of sudden death after myocardial infarction.
We report the results of a randomized double-blind, multicenter trial comparing sulfinpyrazone (200 mg four times a day) and a placebo in the prevention of cardiac mortality among 1558 patients followed for an average of 16 months, beginning 25 to 35 days after a documented myocardial infarction. All but one of the 106 deaths in the group were cardiac; 59 were sudden. The reduction in cardiac mortality at 24 months in the sulfinpyrazone group was 32 per cent (P = 0.058), and the reduction in sudden death was 43 per cent (P = 0.041). The benefit of sulfinpyrazone was attributable entirely to a reduction in sudden death during the second through seventh months after infarction, when there were 35 cardiac deaths in the placebo group and 17 in the sulfinpyrazone group (P = 0.021); of these deaths, 24 in the placebo group and six in the sulfinpyrazone group were sudden cardiac deaths -- a sulfinpyrazone-induced 74 per cent reduction in the calculated mortality rate (P = 0.003). We conclude that sulfinpyrazone prevents sudden cardiac death during the high-risk period shortly after an acute myocardial infarction, but that there is no further apparent effect beyond the seventh month after infarction.
D000368:Aged; D002986:Clinical Trials as Topic; D003645:Death, Sudden; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy / Q000401:mortality*; D010349:Patient Compliance; D010359:Patient Readmission; D010919:Placebos; D011897:Random Allocation; D013442:Sulfinpyrazone / Q000627:therapeutic use*
D010919:Placebos; D013442:Sulfinpyrazone