Treatment for acute myocardial infarction. Overview of randomized clinical trials.
This review summarizes the results of several pharmacological interventions that have been evaluated in the management of acute myocardial infarction. Of these, thrombolytic therapy, aspirin, beta-blockers and angiotensin converting enzyme inhibitors have all been proven to reduce mortality risk and the latter three classes of drugs have also been shown to reduce morbidity. Routine use of heparin or nitrates is not recommended although they may be useful in specific circumstances such as post-infarction angina or large infarcts. Drugs that have as yet not been shown to have a role in the routine management of acute myocardial infarction include Class I antiarrhythmic agents, magnesium and calcium antagonists. Management of patients with acute myocardial infarction can now be appropriately based on the evidence generated from well conducted randomized clinical trials and appropriate therapeutic choices based on such information can be expected to reduce their morbidity and mortality risks.
Yusuf
S
S
Division of Cardiology, McMaster University, Hamilton, Ontario, Canada.
Anand
S
S
Avezum
A
A
Flather
M
M
Coutinho
M
M
D005069:Evaluation Studies as Topic; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy*; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D015996:Survival Rate; D015912:Thrombolytic Therapy / Q000379:methods
D005343:Fibrinolytic Agents