[Short-term versus long-term use of nitrates in acute myocardial infarction].
While previous experimental and small-scaled clinical studies have shown intravenous administration of nitroglycerin in the setting of acute myocardial infarction reduced infarct size and diminished the frequency of mechanical complications, its effect on short-term and long-term outcome has not been established. Recently, two large-scaled clinical trials, GISSI-3 and ISIS-4, have demonstrated unexpected neutral effect of nitrates on subacute phase mortality after myocardial infarction. Long-term nitrate treatment, however, has been indicated by three independent clinical studies that it may increase cardiac events in patients with healed myocardial infarction. Although a large-scaled randomized clinical trial is required to confirm the deleterious effect of nitrates on long-term outcome after myocardial infarction, routine use of nitrates in chronic phase of coronary heart disease cannot be recommended.
Nakamura
Y
Y
First Department of Internal Medicine, Shiga University of Medical Science.
Kinoshita
M
M
D002986:Clinical Trials as Topic; D006801:Humans; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000188:drug therapy*; D005996:Nitroglycerin / Q000008:administration & dosage*; D011379:Prognosis; D013997:Time Factors; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
D014665:Vasodilator Agents; D005996:Nitroglycerin