Predictors of Reinfarction and Sudden Death in a High-Risk Group of Acute Myocardial Infarction Survivors

Hunt, David; Hamer, Angas; Duffield, Anne; Baker, G. A.; Penington, C; Sloman, Graeme

doi:10.1016/s0140-6736(79)90766-9

Cited by 16 publications

(3 citation statements)

References 13 publications

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“…Symptoms of angina pectoris and exercise-induced STchanges during the convalescence following myocardial infarction are possible risk factors for later cardiac death and reinfarction (Hunt et al, 1979;Markiewicz et al, 1977;Thkroux et al, 1979). In the timolol study, the mortality rate in the placebo group was 12.2% in patients with symptoms of angina pectoris during the first six months after entry to the study and 14.9% in patients without symptoms of angina pectoris.…”

Section: Angina Pectorismentioning

confidence: 99%

“…Both preinfarction and postinfarction angina pectoris may be risk factors for cardiac death (Schuster and Bulkley, 1981;Wilhelmsson et al, 1977). Several studies have demonstrated a high prognostic sensitivity of exercise-induced ST changes observed during the convalescent phase following myocardial infarction (Hunt et al, 1979;Markiewicz et al, 1977;ThCroux et al, 1979), but others found no prediction of mortality by exercise test (Noms et al, 1984). The prognostic significance of ventricular arrhythmias is still controversial, but complex ventricular arrhythmias do seem to be of prognostic importance (Moss et al, 1979).…”

Section: Introductionmentioning

confidence: 99%

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Secondary prevention after myocardial infarction: Subgroup analysis of patients at risk in the norwegian timolol multicenter study

Gundersen¹

1985

Clinical Cardiology

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Timolol treatment after myocardial infarction is generally related to a significant reduction in both morality and reinfarction compared with placebo. Retrospective analyses of the timolol study are performed on subgroups of patients with a high placebo mortality. The present study shows that these patients are target groups for secondary prevention, as they benefit most from timolol treatment after myocardial infarction. In patients 65‐75 years of age, the number of cardiac deaths and reinfarctions prevented by timolol treatment is twice as high as that of patients below 65 years of age. Timolol treatment is well tolerated in the older age group and the contraindications for timolol treatment are independent of age up to 75 years. The reduction in mortality and reinfarction is independent of heart size at baseline. However, in patients with cardiomegaly and compensated heart failure on treatment with digitalis and diuretics, timolol treatment may be of special importance because of the very high incidence of cardiac death in this group of patients. In patients with compensated heart failure on treatment with digitalis and diuretics, timolol treatment does not precipitate heart failure. Patients with stable diabetes mellitus basically behave like nondiabetic patients regarding inclusion rate, side effects, and timolol‐related reduction in mortality and reinfarction. Decisions concerning secondary prevention with timolol should be independent of preinfarction and postinfarction angina. In conclusion, 70‐80% of all the patients below 75 years of age surviving myocardial infarction, without contraindication to betablocker treatment, can be treated with timolol 10 mg twice daily to reduce mortality and reinfarction. In contrast to previous routines, secondary prevention with beta blockers should be especially directed to high‐risk patients.

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Section: Angina Pectorismentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Secondary prevention after myocardial infarction: Subgroup analysis of patients at risk in the norwegian timolol multicenter study

Gundersen¹

1985

Clinical Cardiology

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“…Early onset of angina pectoris after myocardial infarction may be a risk factor for cardiac death and reinfarction, especially in those patients with myocardial ischemia at a distance from the original infarct (Moss et al, 1976;Schuster and Bulkley, 1981;Taylor et al, 1980). The prognostic importance of exerciseinduced angina pectoris and depression of the ST segment 4-6 weeks after myocardial infarction is a matter of controversy, and survival seems to correlate better with the exercise tolerance than with the degree of ST depression (Cohn et al, 1972;Hunt et al, 1979;Markiewicz et al, 1977;Norris et al, 1984;Podrid er al., 1981;Selwyn et al, 1981;ThQoux et al, 1979) Treatment with beta blockers has been widely used to obtain symptomatic relief in patients with angina pectoris and has been shown to reduce mortality and reinfarction after a myocardial infarction (The Norwegian Multicenter Study Group, 1981). The aim of the present study was to examine the importance of pre-and postinfarction angina pectoris on long-term mortality and morbidity.…”

Section: Introductionmentioning

confidence: 99%

The importance of pre‐ and postinfarction angina on timolol‐related reduction in mortality and reinfarction

Gundersen

Kjekshus

1985

Clinical Cardiology

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Summary:The importance of a history of angina pectons on long-term timolol treatment after myocardial infarction was studied with respect to mortality and reinfarction. The analyses were performed retrospectively using cohorts from the Norwegian timolol multicenter study. In patients without angina pectoris prior to the infarction, timolol treatment reduced mortality by 61 % and the occurrence of first nonfatal reinfarction by 16.9% as compared with placebo. Patients with preinfarction angina had a reduction in mortality of 2 1.8 % and in first nonfatal reinfarction of 48.6%. The frequency of angina pectons increased from 38% in both treatment groups before the infarction to 59% in the placebo group and 52% in the timolol group the first 6 months after the infarction. In patients without postinfarction angina pectoris, timolol treatment reduced mortality by 30.7% and the number of first nonfatal reinfarctions by 22.7%. The reductions in mortality and reinfarction in patients with postinfarction angina were 43.8% and 38.5%, respectively. Thus, the decision for timolol treatment after myocardial infarction should not be dependent on pre-and postinfarction angina.

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Prediction of 1-year outcome after complicated and uncomplicated myocardial infarction: Bayesian analysis of predischarge exercise test results in 300 patients

Deckers

Fioretti

Brower

et al. 1987

American Heart Journal

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Predictors of Reinfarction and Sudden Death in a High-Risk Group of Acute Myocardial Infarction Survivors

Cited by 16 publications

References 13 publications

Secondary prevention after myocardial infarction: Subgroup analysis of patients at risk in the norwegian timolol multicenter study

Secondary prevention after myocardial infarction: Subgroup analysis of patients at risk in the norwegian timolol multicenter study

The importance of pre‐ and postinfarction angina on timolol‐related reduction in mortality and reinfarction

Prediction of 1-year outcome after complicated and uncomplicated myocardial infarction: Bayesian analysis of predischarge exercise test results in 300 patients

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