What does this research mean for the field?

In acute left ventricular failure complicating myocardial infarction, venodilators (isosorbide dinitrate) and diuretics (frusemide) offer superior immediate hemodynamic benefits compared to arteriolar dilators (hydralazine) and positive inotropes (prenalterol) by reducing filling pressures without inducing tachycardia. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

July 1, 1987Journal of Cardiovascular Pharmacology

First-Line Treatment of Left Ventricular Failure Complicating Acute Myocardial Infarction

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Why the study?

Do different first-line intravenous therapies (frusemide, isosorbide dinitrate, hydralazine, or prenalterol) improve immediate haemodynamic parameters in patients with acute left ventricular failure complicating myocardial infarction?

Population

48 patients with transmural myocardial infarction and a pulmonary artery occluded pressure of greater than…

Comparison

Intravenous diuretic, venodilator, arteriolar… vs Active comparators

Design

RCT, prospective randomised trial

Follow-up

immediate

Authors

SVSatya VermaMotilal Nehru National Institute of Technology BSBernard SilkeSt. James's Hospital MHMusharaf HussainLeeds General Infirmary

Discussion

Member takes

Implication

Supports venodilators/diuretics as initial IV therapy in acute post-MI LV failure; confirms hemodynamic superiority without tachycardia in RCTs.

Structured PICO

Population

48 patients with transmural myocardial infarction and a pulmonary artery occluded pressure (PAOP) of greater than 20 mm Hg, studied within 18 h of admission to a coronary care unit.

Intervention

Intravenous diuretic (frusemide), venodilator (isosorbide dinitrate), arteriolar dilator (hydralazine), or positive inotropic stimulation (prenalterol)

Comparator

Active comparators (the four treatments were compared against each other)

Outcome

Immediate haemodynamic effects (LV filling pressure, cardiac index, and heart rate)surrogate

In acute left ventricular failure following myocardial infarction, venodilators (isosorbide dinitrate) and diuretics (frusemide) provide superior immediate haemodynamic benefits by reducing LV filling pressure without causing tachycardia compared to arteriolar dilators or positive inotropes.

Cite This Study

Verma et al. (1987) studied this question.

synapsesocial.com/papers/6a1c1fc4ea84844e355f7ab3 https://doi.org/10.1097/00005344-198707000-00006

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Implication

Supports venodilators/diuretics as initial IV therapy in acute post-MI LV failure; confirms hemodynamic superiority without tachycardia in RCTs.

First-Line Treatment of Left Ventricular Failure Complicating Acute Myocardial Infarction

Discussion

Member takes

Implication

Structured PICO

Cite This Study

First-Line Treatment of Left Ventricular Failure Complicating Acute Myocardial Infarction

Discussion

Member takes

Implication

Structured PICO

Cite This Study

Also Consider

Also Consider