Pharmacological treatment during AMI and in secondary prevention: the scientific evidence

Table 6. Nitrates. Effect on mortality.
STUDIES DRUGS No. PATIENTS FOLLOW-UP VAR. P
During infarction and 4-6 weeks after
GISSI-3 (1996) [35] NITROGLICERINE
(iv & transdermal)
19,394 42 DAYS -6% 0.28
ISIS 4 (1995) [47] ISOSORBIDE MN 58,050 35 DAYS -3% 0.30
 
META-ANALYSES No. STUDIES No. PATIENTS   VAR P
During infarction
YUSUF (1988) [101] 10 2,000   -35% < 0.01
ISIS-4 (1995) [47] 22 81,908   -6% 0.03

 

ACC/AHA GUIDELINES

Generally the results are not in favour of long-term, routine use in pts. with simple MI. They may be used in CHF, in extensive transmural AMI and in reinfarction

ANMCO-SIC CLINICAL GUIDELINES

There are no proofs on the utility of routine usage. Use only in pts. with angina, silent ischemia or with clinical signs of CHF and together with other vasodilators