Nifedipine in acute myocardial infarction: an assessment of left ventricular function, infarct size, and infarct expansion. A double blind, randomised, placebo controlled trial.
Nifedipine in acute myocardial infarction: an assessment of left ventricular function, infarct size, and infarct expansion. A double blind, randomised, placebo controlled trial.
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硝苯地平治疗急性心肌梗死：评估左心室功能、梗塞面积和梗塞扩张。
作者：
L. Becker;J. Weiss;E. Shapiro;N. Chandra;J. Flaherty;S. Gottlieb;P. Ouyang;E. Mellits;S. Townsend;M. Weisfeldt;B. Healy;G. Gerstenblith
在一项前瞻性、双盲、随机、安慰剂对照试验中，研究了硝苯地平对左心室射血分数、梗死面积和梗死扩展的影响，该试验在132例低风险急性心肌梗死患者中进行，急性心肌梗死持续时间小于12小时，定义为初始左心室射血分数大于35%，临床Killip分级小于或等于II。64名患者被分配到硝苯地平120毫克/天和68安慰剂。在疼痛发作后平均（SEM）8.0（0.2）小时开始治疗，并持续6周。在治疗前和治疗后10天进行门控血池扫描、铊扫描和横断面超声心动图。两组在年龄、性别、心脏危险因素或其他药物的使用方面没有显著差异。平均（SEM）左心室射血分数在治疗前没有差异（硝苯地平组53（2%），安慰剂组55（2%）），在10天没有差异（硝苯地平组54（2%），安慰剂组52（2%）。局部室壁运动或局部射血分数也无差异。两组治疗前（硝苯地平7.8（0.7），安慰剂7.9（0.7））和10天（硝苯地平5.3（0.7），安慰剂5.3（0.7））通过计算机分析定量的铊缺陷相似。在具有高质量超声心动图和系列研究的透壁性梗死患者亚组（n = 30）中，两组之间的平均（SEM）基线梗死节段长度无差异（硝苯地平70（4）mm，安慰剂65（4）mm）;但是，在此情况下，硝苯地平组在最初和10天的研究中显示梗死段长度没有显著变化（± 0.6（3）mm），而安慰剂组的梗死段长度显著增加（± 7.8（4）mm）。7名（47%）安慰剂组患者的梗死节段长度增加>/= 1 cm，而硝苯地平组仅1名（7%）患者。硝苯地平组的平均动脉压在开始时显著下降10%，而安慰剂组的平均动脉压没有变化;这种血压差异持续了10天。因此，虽然硝苯地平早期给药对临床结局和梗死面积没有可检测的影响，但它可能通过后负荷减少机制减少透壁性梗死患者的早期梗死扩展。这些初步结果必须谨慎解释，并需要在更大规模的试验中得到证实。
The influence of nifedipine on left ventricular ejection fraction, infarct size, and infarct expansion was studied in a prospective, double blind, randomised, placebo controlled trial in 132 patients with low risk acute myocardial infarction of less than 12 hours duration, defined by an initial left ventricular ejection fraction greater than 35% and clinical Killip class of less than or equal to II. Sixty four patients were assigned to nifedipine 120 mg/day and 68 to placebo. Treatment was started on average (SEM) 8.0 (0.2) hours after onset of pain and continued for six weeks. Gated blood pool scans, thallium scans, and cross sectional echocardiograms were performed before treatment and at 10 days. There were no significant differences between the two groups in age, sex, cardiac risk factors, or use of other medications. Mean (SEM) global left ventricular ejection fraction was not different before treatment (nifedipine group 53 (2%), placebo group 55 (2%) and did not differ at 10 days (nifedipine group 54 (2%), placebo group 52 (2%). There were also no differences in regional wall motion or regional ejection fractions. Thallium defects quantified by computer analysis were similar in both groups before treatment (nifedipine 7.8 (0.7), placebo 7.9 (0.7)) and at 10 days (nifedipine 5.3 (0.7) placebo 5.3 (0.7)). In the subgroup of patients with transmural infarction who had good quality echocardiograms and serial studies (n = 30), there was no difference in mean (SEM) baseline infarct segment lengths between the two groups (nifedipine 70 (4) mm, placebo 65 (4) mm); however, the nifedipine group demonstrated no significant change in infarct segment length between the initial and 10 day studies ( + 0.6 (3) mm) while there was a significant increase in the infarct segment length in the placebo group (+ 7.8 (4) mm). The infarct segment length increased by >/= 1 cm in seven (47%) placebo patients but in only one (7%) nifedipine patient. The nifedipine group had a significant initial 10% decrease in mean arterial pressure whereas there was no change in the in the placebo group; this blood pressure difference persisted for 10 days. Thus although the early administration of nifedipine has no detectable effect on clinical outcome and infarction size, it may reduce early infarct expansion via an afterload reduction mechanism in patients with transmural infarction. These initial results must be interpreted with caution and need to be confirmed in a larger trial.
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硝苯地平早期和晚期治疗对清醒犬心肌梗死的保护作用。
影响因子：
37.8
作者：
Melin,JA;Becker,LC;Hutchins,GM
通讯作者：
Hutchins,GM
DOI：
10.1016/s0735-1097(84)80203-x
发表时间：
1984-01-01
影响因子：
24
作者：
ERLEBACHER, JA;WEISS, JL;BULKLEY, BH
通讯作者：
BULKLEY, BH
影响因子：
2.8
作者：
ERLEBACHER, JA;WEISS, JL;BULKLEY, BH
通讯作者：
BULKLEY, BH
急性心肌梗死冠状动脉内输注链激酶后受损心肌的功能改善。
DOI：
10.1172/jci110987
发表时间：
1983
期刊：
The Journal of clinical investigation
影响因子：
--
作者：
Stack,RS;Phillips3rd,HR;Grierson,DS;Behar,VS;Kong,Y;Peter,RH;Swain,JL;GreenfieldJr,JC
通讯作者：
GreenfieldJr,JC