- 著者
-
Kinji Ishikawa
Ken Kanamasa
Iwao Ogawa
Toshihiko Takenaka
Takeo Naito
Noriaki Kamata
Tadahiko Yamamoto
Shoji Nakai
Junkichi Hama
Miki Oyaizu
Akio Kimura
Kentaro Yamamoto
Naoko Aso
Miyuki Arai
Hiroshi Yabushita
Ryo Katori
on behalf of the Secondary Prevention Group
- 出版者
- The Japanese Circulation Society
- 雑誌
- JAPANESE CIRCULATION JOURNAL (ISSN:00471828)
- 巻号頁・発行日
- vol.60, no.10, pp.779-788, 1996 (Released:2001-12-25)
- 参考文献数
- 27
- 被引用文献数
-
50
63
Background Nitrates dilate coronary arteries, ameliorate myocardial ischemia, minimize left ventricular remodeling, and reduce mortality in patients with acute myocardial infarction. However, the effects of long-term treatment with nitrates on cardiac events in patients with healed myocardial infarction are not known. Methods and Results A total of 1,002 patients with healed myocardial infarction (789 male and 213 female) were randomly divided into 2 groups: treatment with nitrates or nontreatment. The mean observation period was 18.0 ±19.9 months. Primary end points were nonfatal and fatal recurrent myocardial infarction, death from congestive heart failure, and sudden death. Baseline characteristics of the 2 groups were also compared to determine any effects on outcome. Among the 621 cases treated with nitrates, 41 cases (6.6%) experienced cardiac events during the observation period, whereas only 12 of the 381 cases that were not treated with nitrates (3.1%) had cardiac events. This difference was statistically significant (p<0.05; odds ratio 2.17; 95% confidence interval 1.13-4.19). There were no differences in the incidence of noncardiac death or being lost to follow-up between the 2 groups. Although the precise mechanism of this increase in the occurrence of cardiac events by long-term treatment with nitrates is not clear, nitrate tolerance with possible rebound and neurohormonal effects may be involved. Conclusion Long-term treatment with nitrates increased cardiac events in patients with healed myocardial infarction. (Jpn Circ J 1996; 60: 779 - 788)