Improved Left Ventricular Geometry and Function by Prolonged Nitroglycerin Therapy After Acute Myocardial Infarction

Effects of long‐term transdermal nitrate treatment on left ventricular function in patients following myocardial infarction

“…Nitrates protect LV function and prevent the extension of the infarcted area (and the development of an aneurysm) by lowering the ventricular wall tension and preserving the collagen matrix in the necrotic zone. 7,8,23,24 Moreover, it has been shown that nitrates exert a protective effect on the myocardium following stunning and reperfusion damage. 25 The anti-ischemic properties of nitrates have also been demonstrated in our study, since a significant reduction was noted in the maximal ST-segment depression in response to the stress test in the nitrate group compared with the controls.…”

“…[2][3][4][5] Consequently, nitrates are widely used for the treatment of MI in forms ranging from sublingual to transdermal and intravenous. [6][7][8] Two large multicenter studies, Gruppo Italiano per lo Studio della Sopravvivenza nell' Infarto Miocardico (GISSI-3) and the Fourth International Study of Infarct Survival (ISIS-4), dealt with the effects of nitrates on mortality following MI. 9,10 These two megatrials, in fact, demonstrated no significant decrease in mortality in the nitrate-treated group; merely a small decrease was noted in 6-week mortality, which did not reach a level of significance (for 1,000 patients, this decrease was 2.1 in ISIS-4, and 3.9 in GISSI-3).…”

Transdermal Nitroglycerin Patch Therapy Improves Left Ventricular Function and Prevents Remodeling After Acute Myocardial Infarction

“…12,14 Prolonged nitrate use in animal models of infarction also limits LV dilation and improves EF 14 ; however, there is limited information regarding their long-term effects on remodeling in humans. [15][16][17] This study was designed to investigate the effects of transdermal nitroglycerin patches on LV remodeling over a 6-month period in patients surviving acute Q-wave myocardial infarction.…”