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首页> 外文期刊>Circulation journal >Long-term nitrate therapy after acute myocardial infarction does not improve or aggravate prognosis.
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Long-term nitrate therapy after acute myocardial infarction does not improve or aggravate prognosis.

机译：急性心肌梗死后的长期硝酸盐治疗不能改善或加重预后。

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摘要

BACKGROUND: There is conflicting information about whether nitrate treatment aggravates long-term prognosis, so the present retrospective study was designed to determine the effects of long-term nitrate therapy on major adverse events after acute myocardial infarction (AMI) in the coronary interventional era. METHODS AND RESULTS: Using the Japanese Acute Coronary Syndrome Study database, 1,236 consecutive patients who were hospitalized within 48 h of onset of symptoms of AMI from January to December 2003 were evaluated. All-cause mortality, cardiac events and cardiovascular events were lower in patients treated with nitrates than in the untreated controls. However, these crude comparisons included several confounding factors on nitrate prescription. To minimize the effect of selection bias on outcomes, the technique of propensity score matching for clinical characteristics was used and distortion of effective nitrate treatment was excluded as much as possible. The results of propensity score matching showed that nitrate therapy had no impact on all-cause mortality, cardiac events and cardiovascular events at 30, 60 or 90 days, 6 months, 1 year, and 2 years follow-up. CONCLUSIONS: Long-term nitrate therapy after AMI neither improves nor aggravates prognosis. Prospective randomized clinical trials are warranted to determine the effects of long-term nitrate therapy for secondary prevention of AMI.
机译：背景：关于硝酸盐治疗是否会加重长期预后的信息存在矛盾，因此本回顾性研究旨在确定长期硝酸盐治疗对冠脉介入时代急性心肌梗死（AMI）后主要不良事件的影响。方法和结果：使用日本急性冠状动脉综合症研究数据库，对2003年1月至2003年12月AMI症状发作48小时内住院的1,236例连续患者进行了评估。用硝酸盐治疗的患者的全因死亡率，心脏事件和心血管事件均低于未治疗的对照组。但是，这些粗略的比较包括硝酸盐处方中的几个混淆因素。为了使选择偏倚对结局的影响最小化，使用了针对临床特征的倾向评分匹配技术，并尽可能排除了有效硝酸盐治疗的失真。倾向得分匹配的结果表明，硝酸盐治疗在30、60或90天，6个月，1年和2年的随访中对全因死亡率，心脏事件和心血管事件没有影响。结论：AMI后长期使用硝酸盐治疗既无改善也无预后。必须进行前瞻性随机临床试验来确定长期硝酸盐治疗对AMI的二级预防的影响。

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