Effect of Sodium Nitroprusside on Mortality in Acute Myocardial Infarction
We gave sodium nitroprusside by intravenous infusion to 163 randomly selected patients during the first 24 hours after hospitalization for typical acute myocardial infarction, and we studied its effects on mortality at one week, on the incidence of cardiogenic shock, on clinical signs of left ventri...
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| Veröffentlicht in: | The New England journal of medicine 1982-05, Vol.306 (19), p.1121-1128 |
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| creator | Durrer, Dirk Durrer, Joseph D Lie, Kong Ing van Capelle, Frans J. L |
| description | We gave sodium nitroprusside by intravenous infusion to 163 randomly selected patients during the first 24 hours after hospitalization for typical acute myocardial infarction, and we studied its effects on mortality at one week, on the incidence of cardiogenic shock, on clinical signs of left ventricular failure, and on peak levels of creatine kinase isoenzyme MB. A control group of 165 patients received standard medical treatment and infusion of 5 per cent glucose. The end point of the study was a significant reduction in mortality in the nitroprusside group; this was reached when five deaths had occurred in this group, as compared with 18 among the controls (P |
| doi_str_mv | 10.1056/NEJM198205133061901 |
| format | Article |
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THE ultimate test of the clinical efficacy of an agent capable of limiting the size of an evolving myocardial infarction
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is the demonstration, in a properly controlled trial, of a reduction in mortality and complications in randomly selected patients treated with such a compound. The need for such a test has been heightened by the emergence of myocardial failure and rupture as the main causes of death in acute myocardial infarction, now that malignant arrhythmias can be controlled satisfactorily. We gave sodium nitroprusside by intravenous infusion to patients with typical acute myocardial infarction
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5
6
during the first 24 hours after hospitalization, . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJM198205133061901</identifier><identifier>PMID: 7040955</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>Aged ; Blood Pressure ; Boundaries ; Cardiology ; Clinical Enzyme Tests ; Clinical Trials as Topic ; Creatine ; Creatine kinase ; Creatine Kinase - blood ; Drug dosages ; Electrocardiography ; Female ; Ferricyanides - therapeutic use ; Heart attacks ; Heart diseases ; Heart failure ; Humans ; Infusions, Parenteral ; Intravenous administration ; Isoenzymes ; Male ; Middle Aged ; Mortality ; Myocardial infarction ; Myocardial Infarction - classification ; Myocardial Infarction - diagnosis ; Myocardial Infarction - drug therapy ; Myocardial Infarction - mortality ; Nitroprusside - administration & dosage ; Nitroprusside - adverse effects ; Nitroprusside - therapeutic use ; Pain ; Patients ; Physiology ; Prospective Studies ; Pulmonary arteries ; Random Allocation ; Shock, Cardiogenic - prevention & control ; Sodium ; Sodium nitroprusside ; Ventricle</subject><ispartof>The New England journal of medicine, 1982-05, Vol.306 (19), p.1121-1128</ispartof><rights>Copyright Massachusetts Medical Society May 13, 1982</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c403t-537c119d71a517b68c6ceb273cb3c2530d920b5b47f3f597e8665daad9ad75b53</citedby><cites>FETCH-LOGICAL-c403t-537c119d71a517b68c6ceb273cb3c2530d920b5b47f3f597e8665daad9ad75b53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/1871664774?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,64385,64389,72469</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7040955$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Durrer, Dirk</creatorcontrib><creatorcontrib>Durrer, Joseph D</creatorcontrib><creatorcontrib>Lie, Kong Ing</creatorcontrib><creatorcontrib>van Capelle, Frans J. L</creatorcontrib><title>Effect of Sodium Nitroprusside on Mortality in Acute Myocardial Infarction</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>We gave sodium nitroprusside by intravenous infusion to 163 randomly selected patients during the first 24 hours after hospitalization for typical acute myocardial infarction, and we studied its effects on mortality at one week, on the incidence of cardiogenic shock, on clinical signs of left ventricular failure, and on peak levels of creatine kinase isoenzyme MB. A control group of 165 patients received standard medical treatment and infusion of 5 per cent glucose. The end point of the study was a significant reduction in mortality in the nitroprusside group; this was reached when five deaths had occurred in this group, as compared with 18 among the controls (P<0.05). The incidence of cardiogenic shock, clinical signs of left-heart failure, and mean peak levels of creatine kinase isoenzyme MB were all reduced (P<0.05). The results indicate that infusion of nitroprusside in the early phase of acute infarction limits complications, possibly by reducing infarct size. The drug was particularly effective in anterior-wall infarction. (N Engl J Med. 1982; 306:1121–8.)
THE ultimate test of the clinical efficacy of an agent capable of limiting the size of an evolving myocardial infarction
1
2
3
is the demonstration, in a properly controlled trial, of a reduction in mortality and complications in randomly selected patients treated with such a compound. The need for such a test has been heightened by the emergence of myocardial failure and rupture as the main causes of death in acute myocardial infarction, now that malignant arrhythmias can be controlled satisfactorily. We gave sodium nitroprusside by intravenous infusion to patients with typical acute myocardial infarction
4
5
6
during the first 24 hours after hospitalization, . . .</description><subject>Aged</subject><subject>Blood Pressure</subject><subject>Boundaries</subject><subject>Cardiology</subject><subject>Clinical Enzyme Tests</subject><subject>Clinical Trials as Topic</subject><subject>Creatine</subject><subject>Creatine kinase</subject><subject>Creatine Kinase - blood</subject><subject>Drug dosages</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Ferricyanides - therapeutic use</subject><subject>Heart attacks</subject><subject>Heart diseases</subject><subject>Heart failure</subject><subject>Humans</subject><subject>Infusions, Parenteral</subject><subject>Intravenous administration</subject><subject>Isoenzymes</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Myocardial Infarction - classification</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - drug therapy</subject><subject>Myocardial Infarction - mortality</subject><subject>Nitroprusside - administration & dosage</subject><subject>Nitroprusside - adverse effects</subject><subject>Nitroprusside - therapeutic use</subject><subject>Pain</subject><subject>Patients</subject><subject>Physiology</subject><subject>Prospective Studies</subject><subject>Pulmonary arteries</subject><subject>Random Allocation</subject><subject>Shock, Cardiogenic - prevention & control</subject><subject>Sodium</subject><subject>Sodium nitroprusside</subject><subject>Ventricle</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1982</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kE1LAzEYhIMotVZ_gQgBj7KabL42x1KqtrT1oJ6XbD4gpbupSfbQf-9KiyfxvcxhZp4XBoBbjB4xYvxpM1-usaxKxDAhiGOJ8BkYY0ZIQSni52CMUFkVVEhyCa5S2qLhMJUjMBKIIsnYGCznzlmdYXDwPRjft3Djcwz72KfkjYWhg-sQs9r5fIC-g1PdZwvXh6BVNF7t4KJzKursQ3cNLpzaJXtz0gn4fJ5_zF6L1dvLYjZdFZoikgtGhMZYGoEVw6LhlebaNqUguiG6ZAQZWaKGNVQ44pgUtuKcGaWMVEawhpEJuD9y9zF89Tblehv62A0va1wJzDkVgg4pckzpGFKK1tX76FsVDzVG9c989R_zDa27E7tvWmt-O6e9Bv_h6Ldtqju7bf-lfQO7f3XU</recordid><startdate>19820513</startdate><enddate>19820513</enddate><creator>Durrer, Dirk</creator><creator>Durrer, Joseph D</creator><creator>Lie, Kong Ing</creator><creator>van Capelle, Frans J. 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L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c403t-537c119d71a517b68c6ceb273cb3c2530d920b5b47f3f597e8665daad9ad75b53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1982</creationdate><topic>Aged</topic><topic>Blood Pressure</topic><topic>Boundaries</topic><topic>Cardiology</topic><topic>Clinical Enzyme Tests</topic><topic>Clinical Trials as Topic</topic><topic>Creatine</topic><topic>Creatine kinase</topic><topic>Creatine Kinase - blood</topic><topic>Drug dosages</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Ferricyanides - therapeutic use</topic><topic>Heart attacks</topic><topic>Heart diseases</topic><topic>Heart failure</topic><topic>Humans</topic><topic>Infusions, Parenteral</topic><topic>Intravenous administration</topic><topic>Isoenzymes</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Myocardial Infarction - classification</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - drug therapy</topic><topic>Myocardial Infarction - mortality</topic><topic>Nitroprusside - administration & dosage</topic><topic>Nitroprusside - adverse effects</topic><topic>Nitroprusside - therapeutic use</topic><topic>Pain</topic><topic>Patients</topic><topic>Physiology</topic><topic>Prospective Studies</topic><topic>Pulmonary arteries</topic><topic>Random Allocation</topic><topic>Shock, Cardiogenic - prevention & control</topic><topic>Sodium</topic><topic>Sodium nitroprusside</topic><topic>Ventricle</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Durrer, Dirk</creatorcontrib><creatorcontrib>Durrer, Joseph D</creatorcontrib><creatorcontrib>Lie, Kong Ing</creatorcontrib><creatorcontrib>van Capelle, Frans J. 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L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of Sodium Nitroprusside on Mortality in Acute Myocardial Infarction</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>1982-05-13</date><risdate>1982</risdate><volume>306</volume><issue>19</issue><spage>1121</spage><epage>1128</epage><pages>1121-1128</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract>We gave sodium nitroprusside by intravenous infusion to 163 randomly selected patients during the first 24 hours after hospitalization for typical acute myocardial infarction, and we studied its effects on mortality at one week, on the incidence of cardiogenic shock, on clinical signs of left ventricular failure, and on peak levels of creatine kinase isoenzyme MB. A control group of 165 patients received standard medical treatment and infusion of 5 per cent glucose. The end point of the study was a significant reduction in mortality in the nitroprusside group; this was reached when five deaths had occurred in this group, as compared with 18 among the controls (P<0.05). The incidence of cardiogenic shock, clinical signs of left-heart failure, and mean peak levels of creatine kinase isoenzyme MB were all reduced (P<0.05). The results indicate that infusion of nitroprusside in the early phase of acute infarction limits complications, possibly by reducing infarct size. The drug was particularly effective in anterior-wall infarction. (N Engl J Med. 1982; 306:1121–8.)
THE ultimate test of the clinical efficacy of an agent capable of limiting the size of an evolving myocardial infarction
1
2
3
is the demonstration, in a properly controlled trial, of a reduction in mortality and complications in randomly selected patients treated with such a compound. The need for such a test has been heightened by the emergence of myocardial failure and rupture as the main causes of death in acute myocardial infarction, now that malignant arrhythmias can be controlled satisfactorily. We gave sodium nitroprusside by intravenous infusion to patients with typical acute myocardial infarction
4
5
6
during the first 24 hours after hospitalization, . . .</abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>7040955</pmid><doi>10.1056/NEJM198205133061901</doi><tpages>8</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | The New England journal of medicine, 1982-05, Vol.306 (19), p.1121-1128 |
| issn | 0028-4793 1533-4406 |
| language | eng |
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| subjects | Aged Blood Pressure Boundaries Cardiology Clinical Enzyme Tests Clinical Trials as Topic Creatine Creatine kinase Creatine Kinase - blood Drug dosages Electrocardiography Female Ferricyanides - therapeutic use Heart attacks Heart diseases Heart failure Humans Infusions, Parenteral Intravenous administration Isoenzymes Male Middle Aged Mortality Myocardial infarction Myocardial Infarction - classification Myocardial Infarction - diagnosis Myocardial Infarction - drug therapy Myocardial Infarction - mortality Nitroprusside - administration & dosage Nitroprusside - adverse effects Nitroprusside - therapeutic use Pain Patients Physiology Prospective Studies Pulmonary arteries Random Allocation Shock, Cardiogenic - prevention & control Sodium Sodium nitroprusside Ventricle |
| title | Effect of Sodium Nitroprusside on Mortality in Acute Myocardial Infarction |
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