This study was performed to investigate the risk of
cardiac events by eccentric or continuous dosing of
nitrates in patients with healed
myocardial infarction. A total of 573 patients with healed
myocardial infarction were assigned to one of two groups: a
nitrate-treatment (n =239) and a nontreatment (n =334) group. The
nitrate-treatment group was further subdivided into a group receiving eccentric dosing of
nitrates (n =153) and a group receiving continuous dosing of
nitrates (n =86). The mean observation period was 11.2+/-8.2 months. The
cardiac events investigated were nonfatal and fatal recurrent
myocardial infarction, death from
congestive heart failure,
sudden death, worsening angina and rebound angina. Baseline characteristics were also compared among the three groups to determine any effects on outcome. Among the patients receiving eccentric or continuous dosing of
nitrates, the rates of
cardiac events were 12.7/1,000 person.year and 67.4/1,000 person.year, respectively, whereas the rate was 19.7/1,000 person.year in the nontreated patients. The incidence of
cardiac events was significantly greater in patients receiving continuous dosing of
nitrates than in the nontreated patients (p <0.05). Continuous dosing of
nitrates thus increases
cardiac events, and while eccentric dosing of
nitrates does not increase them, it is also not effective at preventing them in patients with healed
myocardial infarction.