The effects of long-acting nitrates on 5-year cardiac events of patients with coronary thrombolytic therapy for acute myocardial infarction.
OBJECTIVE
A retrospective study was performed to evaluate the effects of using long-term long acting nitrates without a dose-free interval in treating patients undergoing thrombolytic therapy for acute myocardial infarction (MI).


METHODS
A total of 297 patients taking prescribed medication for secondary prevention of the MI were selected for the study. They were divided into a nitrate group consisting of 222 patients who had continuously received long-acting nitrates without a dose-free interval, and a control group consisting of 75 patients who were not able to use the long-acting nitrates because of adverse effects. The primary endpoint was cardiac events, either cardiac death or a nonfatal MI, in five years.


RESULTS
The incidence of primary endpoint in five years was 13.4 percent in the nitrate group and 6.2 percent in the control group, a 2.2-fold increase in risk. However, the difference was not significant. After adjustment for age, there was no statistically significant difference between the incidence of primary endpoint in the nitrate group (9.8%) and that in the control group (5.7%). A Cox proportional-hazards regression analysis revealed that the long-acting nitrates were not related to the incidence of primary endpoint (p=0.23).


CONCLUSIONS
The administration of long-term long-acting nitrates without a dose-free interval had no benefit of reducing the incidence of cardiac events of patients undergoing thrombolytic therapy for acute MI.
Nagao
K
K
Department of Emergency and Critical Care Medicine, Nihon University School of Medicine, Tokyo.
Kanmatsuse
K
K
Ooiwa
K
K
Satou
K
K
Watanabe
I
I
Yamasita
M
M
Kikushima
K
K
D003331:Coronary Vessels; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D009566:Nitrates / Q000627:therapeutic use*; D012189:Retrospective Studies; D015912:Thrombolytic Therapy; D013997:Time Factors
D009566:Nitrates