Intravenous isosorbide-5-mononitrate in the treatment of acute myocardial infarction

Rezaković, D; Goldner, Vladimir; Batinić, Z; Weiss, Marija; Štalec, Janez; Pavičić, Leo

doi:10.1016/0002-9149(90)91313-u

Cited by 7 publications

(1 citation statement)

References 16 publications

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“…With IV NTG, it is easy to "back oft" whenever complications develop. Although long-acting nitrates, such as IV isosorbide dinitrate (ISDN) [36] and IV isosorbide-5-mononitrate (ISMN) [37,38] have been used in Europe, these are not recommended and should only be used with very careful hemodynamic monitoring. Although sublingual NTG is also short-acting, its rapid absorption can result in a precipitous fall in blood pressure and a decrease in cardiac output, so that it, too, should be used with caution in acute MI.…”

Section: Rationale For Choosing IV Nitroglycerinmentioning

confidence: 99%

Use of nitroglycerin for the treatment of acute myocardial infarction

Jugdutt

1994

Heart Vessels

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After a decade of warnings against the use of nitrates in acute myocardial infarction (MI), they are becoming recognized for their potential to salvage left ventricular (LV) myocardium, geometry and function. Low-dose intravenous (IV) nitroglycerin (NTG) infusion for the first 48 h after acute MI, titrated to lower mean blood pressure by 10% to 30%, but not below 80 mmHg, has been shown to be safe, to improve hemodynamics, and to decrease infarct size, infarct expansion, complications, and deaths in a prospective, randomized, single-blind study of 310 patients. In addition, low-dose NTG infusion for the first 48 h, followed by prolonged buccal NTG given during healing after acute MI in an eccentric dose schedule to minimize tolerance, was found to limit further progressive remodeling and preserve LV function. Meta-analysis of nitrate studies in acute MI indicate that they improve survival. Preliminary and ongoing studies suggest that prolonged NTG therapy post MI can produce further benefit.

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Section: Rationale For Choosing IV Nitroglycerinmentioning

confidence: 99%