European heart journal
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European heart journal · Dec 1995
Randomized Controlled Trial Comparative Study Clinical TrialEffect of metoprolol on death and cardiac events during a 2-year period after coronary artery bypass grafting. The MACB Study Group.
To evaluate the effect of long-term treatment with metoprolol after coronary bypass grafting on death and cardiac events. ⋯ Prophylactic treatment with metoprolol over a 2-year period after coronary artery bypass grafting did not reduce death or the development of cardiac events. However, the 95% confidence limits ranged from the possibility of a 30% reduction in events to a 68% increase in events if patients were treated with metoprolol as compared with placebo.
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European heart journal · Dec 1995
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialSafety of flecainide versus propafenone for the long-term management of symptomatic paroxysmal supraventricular tachyarrhythmias. Report from the Flecainide and Propafenone Italian Study (FAPIS) Group.
In order to compare the long-term safety of flecainide and propafenone, an open label, randomized, parallel group study was performed in 335 patients with paroxysmal atrial fibrillation (n = 200) or paroxysmal supraventricular tachycardia (n = 135), and no history of heart disease. Patients were treated with an initial daily dose of flecainide 100 mg (n = 72) or propafenone 450 mg (n = 63) for paroxysmal supraventricular tachycardia and flecainide 200 mg (n = 97) or propafenone 450 mg (n = 103) for paroxysmal atrial fibrillation. Dose escalations were permitted after > or = 2 attacks, up to a maximum of flecainide 300 mg or propafenone 900 mg.day-1. ⋯ Serious proarrhythmic events were infrequent: one case of ventricular tachycardia on propafenone: two cases of atrial fibrillation with rapid ventricular response on flecainide, associated in one patient with pulmonary oedema. An intention-to-treat analysis showed that the probability of 12 months' safe and effective treatment of paroxysmal supraventricular tachycardia was 93% for flecainide and 86% for propafenone (P = 0.24), whereas in paroxysmal atrial fibrillation it was 77% for flecainide and 75% for propafenone (P = 0.72). In conclusion, flecainide and propafenone were safe in the long-term treatment of patients with paroxysmal supraventricular tachyarrhythmias and without evidence of clinically significant heart disease.
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European heart journal · Dec 1995
Randomized Controlled Trial Clinical TrialFurther elevation of the ST segment during the first hour of thrombolysis. A possible early marker of reperfusion.
To evaluate the clinical implications of early electrocardiographic changes during thrombolysis in a randomized study in patients with an acute myocardial infarction. ⋯ Additional ST segment elevation is frequently observed during the first hour of intravenous thrombolysis with streptokinase. Its' association with a subsequent early decline of ST elevation, reduced mortality, a shorter time interval to peak creatine kinase, and a high rate of late recanalization, suggest that in some patients it is one of the earliest markers of reperfusion.