Effect on survival after myocardial infarction of long-term treatment with phenytoin.

Abstract

51 and 75 per cent of subjects at any one follow up visit. There were 19 withdrawals from the treatment group, 10 of which were the result of side effects. There were 5 withdrawals from the control group. According to the original intention to treat, there were 18 deaths at 2 years in the treatment group and 14 deaths in the control group. There was no reduction in the incidence of instantaneous or sudden deaths. Deaths on treatment were not associated with a low phenytoin plasma level. Phenytoin treatment showed no beneficial effects on mortality and was associated with a high incidence of side effects.

The Effect of Long‐term Diphenylhydantoin Therapy on Glucose Tolerance and Insulin Secretion: A Controlled Trial

“…The subjects were drawn from a larger prospective, controlled trial designed to evaluate the prophylactic use of DPH after myocardial infarction (Peter et al, 1978). The details of the patient groups, the method of monitoring DPH treatment and the details of other drug treatment are recorded in previous publications (Heyma et al.…”

Chronic Diphenylhydantoin Therapy Does Not Reduce Plasma 25‐hydroxy‐vitamin D

“…The study was incorporated into a prospective trial investigating the prophylactic value of DPH after myocardial infarction (Peter et al, 1978). After hospital admission with a myocardial infarction patients were stratified according to sex, age in years (less than 40, 40-55, 56-70) and the presence or absence of a past history of myocardial infarction.…”

“…The DPH-treated group received DPH for approximately 2 years, individual dosages being adjusted when necessary at intervals, with the aim of maintaining plasma levels of the drug in the range 40-80 pnol/l, which is generally regarded as therapeutic for treatment of epilepsy and has been suggested for the management of cardiac arrhythmias (Bigger et ul., 1968). Details of the protocol for DPH treatment and monitoring of its plasma levels are published elsewhere (Peter et al, 1978). The subject data are shown in Table 1.…”

Post-myocardial infarction mortality in patients with ventricular premature depolarizations. Canadian Amiodarone Myocardial Infarction Arrhythmia Trial Pilot Study.

“…'0 However, it has been well established by several large studies that VPDs contribute independently to the risk of overall mortality and sudden death.1-5 [7][8][9] See p 928 Six randomized, controlled trials of long-term antiarrhythmic therapy after AMI were reported before 1981. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] None of the trials demonstrated a benefit; three showed a trend against the study drug. Reviews of these trials17'8 point to the problems of inadequate sample size, failure to select high-risk patients, and the use of drugs with relatively low antiarrhythmic potency.…”