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Clinical presentation of acute coronary syndrome in patients previously treated with nitrates


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Title:
Clinical presentation of acute coronary syndrome in patients previously treated with nitrates
Authors:
Latour-Perez, Jaime  
Gómez-Tello, Vicente
Fuset-Cabanes, María Paz
de Miguel Balsa, Eva  
del Nogal Sáez, Frutos
Coves Orts, Francisco Javier
Martín Rodríguez, Carmen
Pino-Izquierdo, Karel
Pavía Pesquera, María de la Concepción
Montón Rodríguez, Antonio José
ARIAM-SEMICYUC Group
Editor:
Italian Federation of Cardiology
Department:
Departamentos de la UMH::Medicina Clínica
Issue Date:
2013
URI:
https://hdl.handle.net/11000/31284
Abstract:
Aims: Several reports have suggested that nitrates limit acute ischaemic damage by a mechanism similar to preconditioning. This study aims to evaluate the effect of chronic oral nitrates on the clinical presentation and short-term outcomes of patients admitted with acute coronary syndrome (ACS).Methods: A retrospective cohort study was conducted in patients with ACS admitted to 62 acute care units from 2010 to 2011. A propensity score-matched samples analysis was performed.Results: We analysed 3171 consecutive patients, of whom 298 (9.4%) were chronically treated with nitrates. Patients previously treated with nitrates had higher comorbidity and disease severity at admission, lower prevalence of ACS with ST elevation, lower troponin elevation, higher prevalence of initial Killip class 2-4 and higher hospital mortality. The propensity score-matched analysis confirmed that previous use of nitrates is independently associated with a lower prevalence of ST-elevation ACS [odds ratio (OR) 0.53, 95% confidence interval (CI) 0.36-0.78; P = 0.0014] and a lower troponin elevation (OR 0.61, 95% CI 0.41-0.92) but not with Killip class on admission (OR 1.18, 95% CI 0.83-1.67, P = 0.3697) or mortality (OR 0.71, 95% CI 0.37-1.38, P = 0.3196).Conclusion: The results support the hypothesis that nitrates have a protective effect on acute ischaemic injury.
Type of document:
application/pdf
Access rights:
info:eu-repo/semantics/closedAccess
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
DOI:
https://doi.org/10.2459/JCM.0b013e32835f4df1
Appears in Collections:
Artículos Medicina Clínica



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