The American journal of cardiology
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Randomized Controlled Trial Multicenter Study Clinical Trial
Efficacy and safety of extended-release isosorbide mononitrate for stable effort angina pectoris.
The efficacy and safety of extended-release isosorbide mononitrate tablets were evaluated in patients with stable effort angina. In a double-blind study, 313 patients with stable effort-induced angina were randomized to receive placebo or extended-release isosorbide mononitrate: 30, 60, 120 or 240 mg once daily in the morning. Serial exercise testing was performed using the standard Bruce treadmill protocol on days 1, 7, 14, 28 and 42 immediately before morning drug administration, and 4 and 12 hours after administration. ⋯ Thus, there was neither significant activity nor demonstrable rebound of effort-induced angina (zero-hour effect) at the end of the dosing interval. Transient headache was the most prevalent adverse experience. Extended-release isosorbide mononitrate (120 and 240 mg administered orally once daily) significantly prolonged exercise time to development of moderate effort-induced angina 4 and 12 hours after dosing during long-term therapy, without development of nitrate tolerance.(ABSTRACT TRUNCATED AT 250 WORDS)
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Randomized Controlled Trial Clinical Trial
Rehospitalization in surviving patients of out-of-hospital ventricular fibrillation (the CASCADE Study). Cardiac Arrest in Seattle: Conventional Amiodarone Drug Evaluation.
Surviving patients of out-of-hospital ventricular fibrillation (VF) often need rehospitalization after initial hospital discharge, but little is known regarding the frequency of or reasons for rehospitalization. Rehospitalization was examined in 224 patients enrolled in the Cardiac Arrest in Seattle: Conventional Amiodarone Drug Evaluation (CASCADE) study, a randomized clinical trial comparing amiodarone with other antiarrhythmic drug therapy in survivors of out-of-hospital VF. The annual rate of rehospitalization was 79/100 patients/year; 168 of 224 patients (75%) were hospitalized at least once before censoring or cardiac mortality. ⋯ However, length of stay for the first rehospitalization was shorter for patients with automatic implantable cardioverter-defibrillators (p = 0.005). More than 50% of patients were rehospitalized in the first year after enrollment; 65% with ejection fractions < or = 0.3 were rehospitalized in the first year. Rehospitalization was a frequent occurrence for surviving patients of out-of-hospital VF, particularly in those with low ejection fractions.