Eccentric dosing of nitrates does not increase cardiac events in patients with healed myocardial infarction.
This study was performed to investigate the risk of cardiac events by eccentric or continuous dosing of nitrates in patients with healed myocardial infarction. A total of 573 patients with healed myocardial infarction were assigned to one of two groups: a nitrate-treatment (n =239) and a nontreatment (n =334) group. The nitrate-treatment group was further subdivided into a group receiving eccentric dosing of nitrates (n =153) and a group receiving continuous dosing of nitrates (n =86). The mean observation period was 11.2+/-8.2 months. The cardiac events investigated were nonfatal and fatal recurrent myocardial infarction, death from congestive heart failure, sudden death, worsening angina and rebound angina. Baseline characteristics were also compared among the three groups to determine any effects on outcome. Among the patients receiving eccentric or continuous dosing of nitrates, the rates of cardiac events were 12.7/1,000 person.year and 67.4/1,000 person.year, respectively, whereas the rate was 19.7/1,000 person.year in the nontreated patients. The incidence of cardiac events was significantly greater in patients receiving continuous dosing of nitrates than in the nontreated patients (p <0.05). Continuous dosing of nitrates thus increases cardiac events, and while eccentric dosing of nitrates does not increase them, it is also not effective at preventing them in patients with healed myocardial infarction.
Kanamasa
Ken
K
Department of Vascular and Geriatric Medicine, Kinki University School of Medicine, Osakasayama, Japan. kanamasa@med.kindai.ac.jp
Naito
Norikatsu
N
Morii
Hideki
H
Nakano
Kazue
K
Tanaka
Yasushi
Y
Kitayama
Koji
K
Haku
Ryo
R
Kai
Tatsuya
T
Yonekawa
Osamu
O
Nagatani
Yusuke
Y
Ishikawa
Kinji
K
D000368:Aged; D000787:Angina Pectoris / Q000188:drug therapy / Q000401:mortality; D005260:Female; D006333:Heart Failure / Q000188:drug therapy / Q000401:mortality; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality*; D009206:Myocardium / Q000473:pathology; D005996:Nitroglycerin / Q000008:administration & dosage*; D012008:Recurrence; D012307:Risk Factors; D015996:Survival Rate; D014665:Vasodilator Agents / Q000008:administration & dosage*; D014945:Wound Healing
D014665:Vasodilator Agents; D005996:Nitroglycerin