title: [Drug treatment for secondary prevention of myocardial infarction].
abstract: The effects of drug treatment on cardiac events for 11 years from January 1986 to December 1996 were investigated in 1,483 patients with myocardial infarction, 1,164 men and 319 women (mean age 60.1 +/- 11.2 years), followed up for 17.4 +/- 20.9 months. Seventy-one patients (4.8%, 33 cases per 1,000 person-year) had cardiac events (recurrent myocardial infarction, sudden death and death by congestive heart failure). Multivariate analysis showed treatment with cholesterol lowering agents and beta-blockers reduced cardiac events, whereas administration of antiarrhythmic agents increased cardiac events. Univariate analysis showed that the incidence of cardiac events was 2.2% in patients treated with cholesterol lowering agents but 6.2% in patients without treatment, showing a significant difference (p < 0.01). The incidence was 3.2% for patients treated with beta-blockers and 6.8% for those without (p < 0.01), showing that beta-blockers were also effective to reduce cardiac events. Antiplatelet agents were also effective (3.7% vs 7.1%, p < 0.01). Calcium antagonists, angiotensin converting enzyme inhibitors and warfarin were not effective. Nitrates (6.0% vs 3.1%, p < 0.01) and antiarrhythmic agents (13.7% vs 3.6%, p < 0.01) increased the incidence of cardiac events. A placebo-controlled, double blind, large clinical multicenter study is required to confirm these results.
authors.affiliation: First Department of Internal Medicine, Kinki University School of Medicine, Osaka.
authors.forename: K
authors.initials: K
authors.lastname: Ishikawa
authors.forename: K
authors.initials: K
authors.lastname: Kanamasa
authors.forename: T
authors.initials: T
authors.lastname: Hayashi
authors.forename: T
authors.initials: T
authors.lastname: Takenaka
authors.forename: T
authors.initials: T
authors.lastname: Inoki
authors.forename: K
authors.initials: K
authors.lastname: Katayama
authors.forename: M
authors.initials: M
authors.lastname: Miyataka
authors.forename: A
authors.initials: A
authors.lastname: Kimura
authors.forename: H
authors.initials: H
authors.lastname: Yabushita
authors.forename: T
authors.initials: T
authors.lastname: Taniwa
authors.forename: A
authors.initials: A
authors.lastname: Ikeda
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D016757:Death, Sudden, Cardiac; D005260:Female; D006333:Heart Failure / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control; D012008:Recurrence
chemical_list: D000319:Adrenergic beta-Antagonists; D000924:Anticholesteremic Agents