Long-Term Nitrate Treatment Increases Cardiac Events in Patients With Healed Myocardial Infarction

Ishikawa, Kinji; Kanamasa, Ken; Ogawa, Ikuko; Takenaka, Toshihiko; Naito, Takeo; Kamata, Noriaki; Yamamoto, Tohru; Nakai, Shoji; Hama, Junkichi; Oyaizu, Miki; Kimura, Akio; Yamamoto, Kentaro; Aso, Naoko; Arai, Miyuki; Yabushita, Hiroshi; Katori, Ryo

doi:10.1253/jcj.60.779

Cited by 72 publications

(56 citation statements)

References 22 publications

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“…During the 4.3 months of observation in the present study, the incidence of cardiac events in the Continuous group was 3.7%, which was significantly higher than the 0.3% seen in the No-nitrate group. This result is consistent with our earlier randomized prospective study (17) reporting that when 1,002 patients with prior myocardial infarction were observed for 1 8.0 months, the incidence of cardiac events was 6.6% in the group treated with nitrates (mainly continuous ISDNtreatment, 20 mg BID, morning and evening), which was significantly higher than the 3. 1% seen in the untreated group.…”

Section: Effect Of Combining Medicationssupporting

confidence: 92%

Intermittent Nitrate Therapy for Prior Myocardial Infarction Does Not Induce Rebound Angina nor Reduce Cardiac Events.

et al. 2000

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Objective Long-term nitrate therapy for ischemic heart disease may cause drug tolerance which diminishes its beneficial effects ; consequently, intermittent administration of nitrates is recommended. With this regimen, however, the potential occurrence of rebound angina during the nitratefree intervals is a source of concern. Subjects and MethodsWecarried out a retrospective study of 606 patients to determine whether rebound angina occurred whenconventional continuousnitrate administration was replaced by intermittent administration as part of a long-term therapy protocol for prior myocardial infarction. Thesubjects were receiving treatment for myocardial infarction and included 293 patients treated with nitrates (Nitrate group) and 313 patients who were not (Nonitrate group). The former included 186 patients who received intermittent nitrate administration (Intermittent group) and 107 patients who received continuous administration (Continuous group). The mean period of observation was 4.3+1.6 months.

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Section: Effect Of Combining Medicationssupporting

confidence: 92%

Intermittent Nitrate Therapy for Prior Myocardial Infarction Does Not Induce Rebound Angina nor Reduce Cardiac Events.

et al. 2000

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“…Furthermore, a study on 19 healthy volunteers documented that isosorbide mononitrate given over 7 days impaired endothelial function due to formation of free radicals (Thomas et al, 2007). In total, epidemiological evidence indicates that chronic administration of long acting nitrates increase rather than decreases fatal and non-fatal events (Ishikawa et al, 1996;Nakamura et al, 1999). This view is confirmed by experiments on human vascular endothelial cells, which show detNO-induced cell cycle arrest and hypertrophy.…”

Section: Long-term Application Of Detno and Other No Donorsmentioning

confidence: 89%

“…In the Fourth International Study of www.intechopen.com Infarct Survival (ISIS-4), there was no significant reduction in five-week mortality and no survival advantage (ISIS-4 (Fourth International Study of Infarct Survival) Collaborative Group, 1995). Chronic administration of long acting nitrates in patients with healed myocardial infarction resulted in an increased number of patients with cardiac events (Ishikawa et al, 1996) and an increased risk of cardiac deaths occurred in CAD patients with long acting nitrates (Nakamura et al, 1999). Furthermore, a study on 19 healthy volunteers documented that isosorbide mononitrate given over 7 days impaired endothelial function due to formation of free radicals (Thomas et al, 2007).…”

Section: Long-term Application Of Detno and Other No Donorsmentioning

confidence: 99%

Nitric Oxide Signalling in Vascular Control and Cardiovascular Risk

Schmidt¹

2012

Cardiovascular Risk Factors

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“…Nitrate Treatment in VSA AMI. 13, 14 There have been scant studies regarding the relationship between long-term nitrate treatment and cardiac events in VSA patients. Therefore, we performed a prospective cohort study to investigate whether long-term nitrate treatment was beneficial for reducing the incidence of cardiac events in VSA patients.…”

Section: Effect Of Nitrates On Cardiac Events In Patients With Coronamentioning

confidence: 99%

Effect of Long-Term Nitrate Treatment on Cardiac Events in Patients With Vasospastic Angina

Kosugi

Nakagomi

Shibui

et al. 2011

Circ J

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Background:Nitrates have been widely used as anti-ischemic drugs in patients with vasospastic angina (VSA). However, the effect of long-term nitrate treatment on cardiac events in VSA patients remains unclear. Methods and Results:Two-hundred and thirty-one patients with VSA who had not been receiving any antiischemic drugs, including calcium channel blockers (CCBs), nitrates, nicorandil, or any combination of these medications were prospectively enrolled in the present study. All patients had a positive acetylcholine provocation test with normal coronary angiograms, and they received CCBs after enrollment. They were divided into 2 groups based on whether nitrates were included in the treatment: a nitrate group (n=86) and a without nitrate group (n=145). The baseline clinical characteristics and frequency of anginal attacks within 48 h before enrollment were similar between the 2 groups. With a median follow-up period of 70.5 months, 29 patients developed cardiac events, including 7 sudden cardiac deaths and 22 re-admissions for acute coronary syndrome. Cardiac events occurred in 19.8% of the nitrate group and in only 8.3% of the patients who were not taking nitrates (P=0.015). In a multivariate analysis, long-term nitrate treatment (hazard ratio 5.18, 95% confidence interval: 1.69-15.89, P=0.004) was an independent predictor of cardiac events. Conclusions:These data indicate that long-term nitrate treatment in addition to CCBs might not reduce cardiac events in VSA patients. (Circ J 2011; 75: 2196 - 2205

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Long-Term Nitrate Treatment Increases Cardiac Events in Patients With Healed Myocardial Infarction

Abstract: Long-term treatment with nitrates increased cardiac events in patients with healed myocardial infarction.

Cited by 72 publications

References 22 publications

Intermittent Nitrate Therapy for Prior Myocardial Infarction Does Not Induce Rebound Angina nor Reduce Cardiac Events.

Intermittent Nitrate Therapy for Prior Myocardial Infarction Does Not Induce Rebound Angina nor Reduce Cardiac Events.

Nitric Oxide Signalling in Vascular Control and Cardiovascular Risk

Effect of Long-Term Nitrate Treatment on Cardiac Events in Patients With Vasospastic Angina

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