The effects of long-acting nitrates on 5-year cardiac events of patients with coronary thrombolytic therapy for acute myocardial infarction

Objective A retrospective study was performed to evaluate the effects of us ing long-term long acting nitrates without a dose-free interval in treating patients undergoing thrombolytic therapy for acute myocardial infarction ( MI), Patients and Methods A total of 297 patients taking prescribed medication f or secondary prevention of the MI were selected for the study. They were di vided into a nitrate group consisting of 222 patients who had continuously received long-acting nitrates without a dose-free interval, and a control g roup consisting of 75 patients who were not able to use the long-acting nit rates because of adverse effects. The primary endpoint was cardiac events, either cardiac death or a nonfatal MI, in five years. Results The incidence of primary endpoint in five years was 13.4 percent in the nitrate group and 6.2 percent in the control group, a 2.2-fold increas e in risk. However, the difference was not significant. After adjustment fo r age, there was no statistically significant difference between the incide nce of primary endpoint in the nitrate group (9.8%) and that in the control group (5.7%), A Cox proportional-hazards regression analysis revealed that the long-acting nitrates were not related to the incidence of primary endp oint (p=0.23), Conclusion The administration of long-term long-acting nitrates without a d ose-free interval had no benefit of reducing the incidence of cardiac event s of patients undergoing thrombolytic therapy for acute MI.