TY - JOUR
T1 - Diltiazem and Reinfarction in Patients with Non-Q-Wave Myocardial Infarction
AU - the Diltiazem Reinfarction Study Group
AU - Gibson, Robert S.
AU - Boden, William E.
AU - Theroux, Pierre
AU - Strauss, Hans D.
AU - Pratt, Craig M.
AU - Gheorghiade, Mihai
AU - Capone, Robert J.
AU - Crawford, Michael H.
AU - Schlant, Robert C.
AU - Kleiger, Robert E.
AU - Young, Phillip M.
AU - Schechtman, Kenneth
AU - Perryman, M. Benjamin
AU - Roberts, Robert
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 1986/8/14
Y1 - 1986/8/14
N2 - We performed a multicenter, double-blind, randomized study to evaluate the effect of diltiazem on reinfarction after a non-Q-wave myocardial infarction. Nine centers enrolled 576 patients: 287 received diltiazem (90 mg every six hours) and 289 received placebo. Treatment was initiated 24 to 72 hours after the onset of infarction and continued for up to 14 days. The primary end point, reinfarction, was defined as an abnormal reelevation of MB creatine kinase in plasma within 14 days. Reinfarction occurred in 27 patients in the placebo group (9.3 percent) and in 15 in the diltiazem group (5.2 percent) - 51.2 percent reduction in cumulative life-table incidence (P = 0.0297; 90 percent confidence interval, 7 to 67 percent). Diltiazem reduced the frequency of refractory postinfarction angina (a secondary end point) by 49.7 percent (P = 0.0345; 90 percent confidence interval, 6 to 73 percent). Mortality was similar in the two groups (3.1 and 3.8 percent, respectively, in the placebo and diltiazem groups), but adverse drug reactions (most of which were mild) were more common in the diltiazem group. Nevertheless, the drug was well tolerated, despite concurrent treatment with beta-blockers in 61 percent of the patients. We conclude that diltiazem was effective in preventing early reinfarction and severe angina after non-Q-wave infarction and that it was also safe and generally well tolerated.
AB - We performed a multicenter, double-blind, randomized study to evaluate the effect of diltiazem on reinfarction after a non-Q-wave myocardial infarction. Nine centers enrolled 576 patients: 287 received diltiazem (90 mg every six hours) and 289 received placebo. Treatment was initiated 24 to 72 hours after the onset of infarction and continued for up to 14 days. The primary end point, reinfarction, was defined as an abnormal reelevation of MB creatine kinase in plasma within 14 days. Reinfarction occurred in 27 patients in the placebo group (9.3 percent) and in 15 in the diltiazem group (5.2 percent) - 51.2 percent reduction in cumulative life-table incidence (P = 0.0297; 90 percent confidence interval, 7 to 67 percent). Diltiazem reduced the frequency of refractory postinfarction angina (a secondary end point) by 49.7 percent (P = 0.0345; 90 percent confidence interval, 6 to 73 percent). Mortality was similar in the two groups (3.1 and 3.8 percent, respectively, in the placebo and diltiazem groups), but adverse drug reactions (most of which were mild) were more common in the diltiazem group. Nevertheless, the drug was well tolerated, despite concurrent treatment with beta-blockers in 61 percent of the patients. We conclude that diltiazem was effective in preventing early reinfarction and severe angina after non-Q-wave infarction and that it was also safe and generally well tolerated.
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U2 - 10.1056/NEJM198608143150704
DO - 10.1056/NEJM198608143150704
M3 - Article
C2 - 3526151
AN - SCOPUS:0022517730
VL - 315
SP - 423
EP - 429
JO - New England Journal of Medicine
JF - New England Journal of Medicine
SN - 0028-4793
IS - 7
ER -