[Possible evidence for a reduction of early and late mortality during nitroglycerin therapy in acute myocardial infarction]

Abstract

60 patients with acute myocardial infarction were randomized in two groups to examine the influence of intravenous nitroglycerin on early and late prognosis. 31 patients received intravenous nitroglycerin in the first 2-3 days. One cardiac death following an emergency bypass operation occurred in the early phase during the first 14 days (3%). 5 of the 29 patients in the control group died during the same period (17%), however, cardiac cause was not entirely clear in one case.--In the late phase on the average 1 1/2 years later 3 deaths were registered in 27 treated patients (11%) compared to 7 of 23 patients in the control group (30%). For this difference in mortality reduced infarct size as well as possibly the higher dose of nitrates (38 versus 21 mg/die) were responsible. Sudden deaths and the incidence of reinfarction with and without death during the early and late observation period were significantly lower in the nitroglycerin group (11% - 3 patients) compared to the control group (39% - 11 patients, p less than 0.01).--This pilot result seems to indicate a beneficial influence of nitroglycerin therapy in the acute phase for prognosis for the short term and long term follow up. The result should simulate trials in larger patient groups.