Abstract
Over 30 months 9292 consecutive patients admitted to nine coronary care units with suspected myocardial infarction were considered for admission to a randomised double blind study comparing the effect on mortality of nifedipine 10 mg four times a day with that of placebo. Among the 4801 patients excluded from the study the overall one month fatality rate was 18.2% and the one month fatality rate in those with definite myocardial infarction 26.8%. A total of 4491 patients fulfilled the entry criteria and were randomly allocated to nifedipine or placebo immediately after assessment in the coronary care unit. Roughly 64% of patients in both treatment groups sustained an acute myocardial infarction. The overall one month fatality rates were 6.3% in the placebo treated group and 6.7% in the nifedipine treated group. Most of the deaths occurred in patients with an in hospital diagnosis of myocardial infarction, and their one month fatality rates were 9.3% for the placebo group and 10.2% for the nifedipine group. These differences were not statistically significant. Subgroup analysis also did not suggest any particular group of patients with suspected acute myocardial infarction who might benefit from early nifedipine treatment in the dose studied.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Hanrath P., Kremer P., Bleifeld W. Influence of nifedipine on left ventricular dysfunction at rest and during exercise. Eur Heart J. 1982 Aug;3(4):325–330. doi: 10.1093/oxfordjournals.eurheartj.a061314. [DOI] [PubMed] [Google Scholar]
- Hillis L. D., Fishbein M. C., Braunwald E., Maroko P. R. The influence of the time interval between coronary artery occlusion and the administration of hyaluronidase on salvage of ischemic myocardium in dogs. Circ Res. 1977 Jul;41(1):26–31. doi: 10.1161/01.res.41.1.26. [DOI] [PubMed] [Google Scholar]
- Miura M., Thomas R., Ganz W., Sokol T., Shell W. E., Toshimitsu T., Kwan A. C., Singh B. N. The effect of delay in propranolol administration on reduction of myocardial infarct size after experimental coronary artery occlusion in dogs. Circulation. 1979 Jun;59(6):1148–1157. doi: 10.1161/01.cir.59.6.1148. [DOI] [PubMed] [Google Scholar]
- Muller J. E., Morrison J., Stone P. H., Rude R. E., Rosner B., Roberts R., Pearle D. L., Turi Z. G., Schneider J. F., Serfas D. H. Nifedipine therapy for patients with threatened and acute myocardial infarction: a randomized, double-blind, placebo-controlled comparison. Circulation. 1984 Apr;69(4):740–747. doi: 10.1161/01.cir.69.4.740. [DOI] [PubMed] [Google Scholar]
- Opie L. H. Calcium antagonists. Mechanisms, therapeutic indications and reservations: a review. Q J Med. 1984 Winter;53(209):1–16. [PubMed] [Google Scholar]
- Reimer K. A., Lowe J. E., Rasmussen M. M., Jennings R. B. The wavefront phenomenon of ischemic cell death. 1. Myocardial infarct size vs duration of coronary occlusion in dogs. Circulation. 1977 Nov;56(5):786–794. doi: 10.1161/01.cir.56.5.786. [DOI] [PubMed] [Google Scholar]
- Robson R. H., Vishwanath M. C. Nifedipine and beta-blockade as a cause of cardiac failure. Br Med J (Clin Res Ed) 1982 Jan 9;284(6309):104–104. doi: 10.1136/bmj.284.6309.104. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rowland E., Evans T., Krikler D. Effect of nifedipine on atrioventricular conduction as compared with verapamil. Intracardiac electrophysiological study. Br Heart J. 1979 Aug;42(2):124–127. doi: 10.1136/hrt.42.2.124. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Serruys P. W., Brower R. W., ten Katen H. J., Bom A. H., Hugenholtz P. G. Regional wall motion from radiopaque markers after intravenous and intracoronary injections of nifedipine. Circulation. 1981 Mar;63(3):584–591. doi: 10.1161/01.cir.63.3.584. [DOI] [PubMed] [Google Scholar]