Mononitrates as monotherapy in the prophylactic treatment of angina pectoris.

This article reviews the results of double-blind comparative studies on the therapeutic use of isosorbide 5-mononitrate as monotherapy in the prophylaxis of angina pectoris. Isosorbide 5-mononitrate appears at least as effective as the same dosage of isosorbide dinitrate and is probably superior to the calcium antagonists. Recent data have shown that isosorbide 5-mononitrate in a controlled-release formulation given once daily has a significantly better antianginal effect than placebo without inducing the development of tolerance.

Pharmacokinetics of felodipine and effect on digoxin plasma levels in patients with heart failure.

Some calcium antagonist drugs used in hypertension and cardiac diseases have been shown to increase plasma digoxin levels mainly as a result of reduced renal clearance. Felodipine is a new dihydropyridine calcium antagonist drug with cardiovascular effects, whose pharmacokinetics and effects on plasma digoxin levels have been studied in patients with left ventricular failure. 12 patients (11 men) on long term digoxin therapy were given 2.

Unexpected death in patients suffering from eating disorders. A medico-legal study.

Medico-legal investigation into causes of unexpected death of five persons who suffered from eating disorders did not give distinct pathoanatomical explanations. The analysis disclosed a number of risk factors whose interplay may have resulted in a circulatory catastrophy. These factors were of organisational and ideological character: simultaneous treatment at different departments, lack of contact with psychiatrists, or unclear criteria for admission to hospital; or somatic: circulatory and electrocardiographic S-T and T wave abnormalities, hypopotassemia and hypoglycemia, as well as anergy of the emaciated patient which may have led to symptoms of bronchopneumonia being overlooked.

The effect of isosorbide-5-mononitrate (5-ISMN) Durules on exercise tolerance in patients with exertional angina pectoris. A placebo controlled study.

Twenty-four patients with stable exercise-induced angina pectoris entered a double-blind cross-over study. Isosorbide-5-mononitrate (5-ISMN) 60 mg in a controlled release formulation (Durules) given once daily was compared with identical placebo. The exercise tolerance was determined by bicycle ergometry before and 3 h after a single dose of 5-ISMN and following one week's treatment with 5-ISMN and placebo.

Long-term treatment with metoprolol after myocardial infarction: effect on 3 year mortality and morbidity.

The effects of metoprolol treatment in patients surviving acute myocardial infarction have been investigated in a double-blind randomized study. The patients were stratified according to age, infarct size and type of ventricular arrhythmias before administration of metoprolol, 100 mg twice daily (n = 154), or placebo (n = 147). All patients were followed up for 36 months.

Genetic and environmental determinants of cholesterol and HDL-cholesterol concentrations in blood.

Serum cholesterol and HDL-cholesterol have been studied in 274 Swedish nuclear families. The families were ascertained through the Swedish twin registry and consisted of married mono- and dizygous twins, their spouses and with at least one adult child. Total cholesterol was determined using an enzymatic colorimetric method and HDL-cholesterol by the heparin-manganese chloride precipitation method.

Ventricular arrhythmias and left ventricular dysfunction in familial cardiomyopathy.

In familial cardiomyopathy (CM), different forms of myocardial abnormalities including asymmetric and symmetric hypertrophy and dilated left ventricles are presented, mostly showing varying hereditary penetrance. This study presents a family with CM including three major clinical manifestations: severe ventricular arrhythmias, repolarization abnormalities and left ventricular hypertrophy. This triad was strikingly consistent in the two generations examined.

Metoprolol treatment after acute myocardial infarction. Effects on ventricular arrhythmias and exercise tests during 6 months.

One hundred and six patients on double-blind treatment with placebo or metoprolol, 100 mg b.i.d.

Pre-beta 1-lipoprotein in patients with ischemic heart disease. Genetic determination and relation to early insulin response.

The genetic determination of pre-beta 1-lipoprotein and its relation to insulin response was studied in 18 male monozygotic and 13 male dizygotic twin pairs, aged 51-74. They had been selected from the Swedish Twin Registry by means of an angina pectoris questionnaire. Results revealed a heritability index for the pre-beta 1-lipoprotein, determined quantitatively, to be as high as 0.

QTc intervals in acute myocardial infarction: first-year prognostic implications.

Corrected QT (QTc) intervals were measured retrospectively in 160 consecutive survivors of acute myocardial infarction under 66 years of age. Calculations were made the first 2 d in the coronary care unit (CCU), the first post-CCU day, at discharge, and at 1-3, 6, and 12 months after discharge. All patients were in sinus rhythm and without bundle branch block at discharge from the hospital.

Effect of metoprolol on QTc intervals after acute myocardial infarction.

The effect of metoprolol on corrected QT interval (QTc) was studied retrospectively in 111 survivors of AMI below 70 years of age. Prior to discharge the patients were stratified by age, infarction size and ventricular arrhythmias and randomized. Metoprolol, 100 mg b.

QTc intervals at discharge after acute myocardial infarction and long-term prognosis.

QTc intervals were measured retrospectively in 46.3 survivors of AMI with a mean age of 65 years. The measurement was made one at discharge from hospital.

Early and sudden deaths after myocardial infarction. A report from the Swedish CCU study.

1329 patients were discharged alive after acute myocardial infarction initially treated in a CCU. In a five-year follow-up, 537 (40%) of the patients died. Routine data registered uniformly during the CCU period showed that, apart from age, the most important factors regarding long-term prognosis in general were previous ischaemic heart disease and direct or indirect signs of heart failure registered in the CCU.

Dobutamine in left heart failure after acute myocardial infarction.

Dobutamine, a new positive inotropic drug, was given as i.v. infusion at a rate of 2.

Early mobilization and discharge of patients with acute myocardial infarction. A prospective study using risk indicators and early exercise tests.

Consecutive patients (n=184) surviving 48 hours in a coronary care unit were divided into one rapidly (RM) (n=55, 30%) and one conventionally mobilized (CM) group (n=129, 70%). The selection of RM patients was based on the absence of five early risk indicators (RI), reflecting electrical and mechanical heart dysfunction. During after-care, five late RIs were evaluated, including a submaximal bicycle exercise test to 50 W, which excluded nine (16%) additional patients from the RM group.