No abstract

Many physicians find it difficult to decide whether or not a patient sustaining a mild episode of acute myocardial infarction should be treated with anticoagulant drugs. The Committee for the Evaluation of Anticoagulants in the Treatment of Coronary Occlusion with Myocardial Infarction (American Heart Association) has recommended the employment of such therapy in patients with this disease, unless contraindications to anticoagulant therapy exist. Data are presented to show that in "good risk" patients treated conservatively without anticoagulants, the mortality rate and incidence of thromboembolism are strikingly low. Consequently, even the maximum benefit theoretically obtainable from the employment of dicumarol in these cases is not sufficient to justify the hazard entailed in its use. It is therefore recommended that anticoagulants be employed only in the more serious attacks of the disease.

No abstract

Recognition of the value of glyceryl trinitrate (nitroglycerine) in the treatment and pr evention of anginal attacks has confirmed the belief that coronarv blood flow may be influenced favorablv by drug therapy and has led to a search for vasodilators capable of more prolonged action. The most popular of the newer agents which are alleged to have this desirable effect are Metamine, Paveril, Nitroglyn and Peritrate. In order to evaluate these drugs, the modifying action of each agent on the electrocardiographic response to standard exercise (Master two-step test) was recorded and compared in 21 carefully selected patients with coronary disease. Analysis of the results obtained with varying dosage administered from one to six hours prior to exercise disclosed that Peritrate was vastly superior to the other three drugs and that it alone was worthy of the designation "long-acting coronary v-asodilator."T HE administration of nitroglycerine (glyceryl trinitrate) in the treatment of angina pectoris has long been recognized as the most effective measure for the relief of the acute attack. Although the drug is also unexcelled prophylactically when employed prior to contemplated exertion, the relatively short duration of its action obviously does not afford prolonged protection for the patient afflicted with this disease. For many years, therefore, the search has continued for a long acting coronary vasodilator which is capable of reducing the frequency and severity of anginal attacks by routine daily administration. Although numerous drugs have been characterized by their individual sponsors as fulfilling this iieed, few have been able to withstand the test of time and clinical usage. In previous studies'-4 we have compared a number of "'vasodilating" agents by recording their respective actions in modifying the electro-A joint project

No abstract