Nifedipine therapy for patients with threatened and acute myocardial infarction: a randomized, double-blind, placebo-controlled comparison.
Nifedipine therapy for patients with threatened and acute myocardial infarction: a randomized, double-blind, placebo-controlled comparison.
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硝苯地平治疗先兆急性心肌梗死患者：随机、双盲、安慰剂对照比较。
DOI：
10.1161/01.cir.69.4.740
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发表时间：
1984
期刊：
影响因子：
37.8
通讯作者：
E. Braunwald
中科院分区：
文献类型：
--
作者：
J. Muller;J. Morrison;R. Rude;B. Rosner;R. Roberts;M. D. D. L. Pearle;M. Turi;J. Schneider;D. Serfas;Carol Tate;Ellenjane Scheiner;B. Sobel;C. Hennekens;E. Braunwald
初步的临床和实验室观察表明，硝苯地平可能通过逆转冠脉痉挛来预防先兆心肌梗死的进展，或者可能限制急性心肌梗死过程中的坏死。我们筛选了3143例持续时间超过45min的缺血性疼痛患者，并将符合条件的105例先兆心肌梗死患者和66例急性心肌梗死患者随机分配给硝苯地平(20 mg，每4小时口服一次，连续14天)或安慰剂加标准护理。在疼痛发作后4.6+/-0.1小时开始治疗。心肌梗死面积指数用MB-肌酸激酶(CK)法计算，以CK-geq/m2+/-SE表示。硝苯地平对先兆心肌梗死患者进展为心肌梗死的发生率没有显著影响(安慰剂治疗的48人中有36人[75%]，硝苯地平治疗的57人中有43人[75%])。此外，安慰剂和硝苯地平治疗的先兆心肌梗死患者和急性心肌梗死患者的梗塞面积指数相似(分别为16.9+/-1.5MB-CK-geq/m2，n=65和17.0+/-1.5MB-CK-geq/m2，n=68)。在171名随机分配到药物或安慰剂的符合条件的患者中，6个月死亡率没有显著差异(安慰剂组为8.5%，硝苯地平组为10.1%，NS)，但硝苯地平治疗组在随机分组后2周的死亡率显著高于对照组(安慰剂组为0%，硝苯地平组为7.9%，p=.018)。(摘录，250字)
Preliminary clinical and laboratory observations suggest that nifedipine might prevent progression of threatened myocardial infarction by reversing coronary spasm or might limit necrosis during the course of acute myocardial infarction. We screened 3143 patients with ischemic pain of greater than 45 min duration and randomly assigned 105 eligible patients with threatened myocardial infarction and 66 with acute myocardial infarction to receive nifedipine (20 mg orally every 4 hr for 14 days) or placebo plus standard care. Treatment was started 4.6 +/- 0.1 hr after the onset of pain. Infarct size index was calculated by the MB-creatine kinase (CK) method and expressed as CK-geq/m2 +/- SE. The incidence of progression to infarction among patients with threatened myocardial infarction was not significantly altered by nifedipine (36 of 48 [75%] for placebo-treated and 43 of 57 [75%] for nifedipine-treated patients). Furthermore, infarct size index was similar among placebo- and nifedipine-treated patients (16.9 +/- 1.5 MB-CK-geq/m2, n = 65, and 17.0 +/- 1.5 MB-CK-geq/m2, n = 68, respectively) with threatened myocardial infarction who exhibited infarction and for those with acute myocardial infarction. Among the 171 eligible patients randomly assigned to drug or placebo, 6 month mortality did not differ significantly (8.5% for placebo vs 10.1% for nifedipine, NS), but mortality in the 2 weeks after randomization was significantly higher for nifedipine-treated patients (0% for placebo compared with 7.9% for nifedipine, p = .018).(ABSTRACT TRUNCATED AT 250 WORDS)
影响因子：
37.8
作者：
HACKEL, DB;REIMER, KA;ROBERTS, R
通讯作者：
ROBERTS, R