Why the study?
Does methylprednisolone reduce 7-day mortality in patients with cardiac failure following an acute myocardial infarction?
Does methylprednisolone reduce 7-day mortality in patients with cardiac failure following an acute myocardial infarction?
Methylprednisolone may reduce short-term mortality in a specific high-risk subset of post-myocardial infarction patients with heart failure who present late and require diuretics.
May warrant methylprednisolone in late post-MI HF patients needing diuretics; extends RCT evidence to this high-risk subset.
In studies of patients with cardiac failure following an acute myocardial infarction, 1114 patients were followed for 7-day mortality. In the 45% of patients receiving diuretics on day 1, the death rate was twice that of patients not receiving diuretics. In patients treated 6 to 12 hours following the onset of chest pain, mortality was 2.8 times that of patients treated within 6 hours of the onset of chest pain. Randomization to methylprednisolone sodium succinate (MPSS, Solu-Medrol Sterile Powder, The Upjohn Company) did not improve the low mortality rates of those patients who did not need diuretics nor who were treated early. However, patients who were treated late and who needed diuretics and who were randomized to MPSS had a death rate half that of those who received placebo.
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Derek F. Stubbs (1986) studied this question.
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