Document Detail


Electrocardiographic subset analysis of diltiazem administration on long-term outcome after acute myocardial infarction. The Multicenter Diltiazem Post-Infarction Trial Research Group.
MedLine Citation:
PMID:  1994656     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effect of diltiazem on long-term outcome after acute myocardial infarction (AMI) was assessed in 2,377 patients enrolled in the Multicenter Diltiazem Post-Infarction Trial and subsequently followed for 25 +/- 8 months. The study population included 855 patients (36%) with at least 1 prior AMI before the index infarction and 1,522 patients (64%) with a first AMI, of whom 409 (27%) had a first non-Q-wave AMI, 664 (44%) a first inferior Q-wave AMI, and 449 (30%) a first anterior Q-wave AMI. This post hoc analysis revealed that, among patients with first non-Q-wave and first inferior Q-wave AMI, there were fewer cardiac events during follow-up in the diltiazem than in the placebo group, and that the reverse was true for patients with first anterior Q-wave AMI or prior infarction. The diltiazem:placebo Cox hazard ratio (95% confidence limits) for the trial primary end point (cardiac death or nonfatal reinfarction, whichever occurred first) was: first non-Q-wave AMI-0.48 (0.26, 0.89); first inferior Q-wave AMI-0.66 (0.40, 1.09); first anterior Q-wave AMI-0.82 (0.51, 1.31); and prior AMI-1.11 (0.85, 1.44). Use of cardiac death alone as an end point gave an even more sharply focused treatment difference: first non-Q-wave AMI-0.46 (0.18, 1.21); first inferior Q-wave AMI-0.53 (0.27, 1.06); first anterior Q-wave AMI-1.28 (0.68, 2.40); prior infarction-1.26 (0.90, 1.77). Further analysis revealed that these differences in the effect of diltiazem in large part reflected the different status of the 4 electrocardiographically defined subsets in terms of left ventricular function.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
W E Boden; R J Krone; R E Kleiger; D Oakes; H Greenberg; E J Dwyer; J P Miller; J Abrams; J Coromilas; R Goldstein
Related Documents :
2346966 - Mechanism of ecg changes and arrhythmogenic properties of low osmolality contrast media...
24776236 - Real time myocardial contrast echocardiography to predict left ventricular wall motion ...
2272066 - Interplay between adrenaline and interbeat interval on ventricular repolarisation in in...
426966 - Electrocardiographic changes resembling myocardial ischaemia in asymptomatic men with n...
10684726 - Endothelin antagonists diminish postischemic microvascular incompetence and necrosis in...
1505656 - Factor viii and coronary heart disease.
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of cardiology     Volume:  67     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1991 Feb 
Date Detail:
Created Date:  1991-03-20     Completed Date:  1991-03-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  335-42     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Section, Veterans Administration Medical Center, Boston, Massachusetts 02130.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Diltiazem / therapeutic use*
Double-Blind Method
Electrocardiography*
Female
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / diagnosis,  drug therapy*,  mortality
Survival Analysis
Ventricular Function, Left / physiology
Chemical
Reg. No./Substance:
42399-41-7/Diltiazem

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Gluteoplasty: a ten-year report.
Next Document:  Exercise echocardiography and technetium-99m MIBI single-photon emission computed tomography in the ...