Skip to main content
SpringerLink
Log in

Drug trials in myocardial infarction

Lessons to be learned from the anturane reinfarction trial

  • Editorial
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Summary

Drug intervention trials in myocardial infarction are unlikely to prove an effect unless planning takes into consideration: (1) the multiple causes for cardiac mortality after myocardial infarction, and the likelihood that the drug being tested is unlikely to affect all of these causes; (2) the different mortality rates at different periods following the qualifying infarct; (3) the contribution of each cause to the total mortality encountered during each period; and (4) the elimination of the various dilution factors which plague those trials based only on an intention to treat rather than on the efficacy of the drug when administered properly to eligible patients. Prospective studies should be designed with these points in mind. Otherwise one will be confronted with the usual criticisms and scepticism associated with a retrospective analysis. In this regard, the Anturane Reinfarction Trial represents an advance in trial design, and the lessons to be learned from it provide a basis for further improvements.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Anturane Trial Research Group (in press) Prevention of sudden death after myocardial infarction by sulfinpyrazone. N Engl J Med

  2. Sackett DL, Gent M (1979) Controversy in counting and attributing events in clinical trials. N Engl J Med 301: 1410–1412

    Google Scholar 

  3. Madsen EB, Svendsen TL, Rasmussen S, Pedersen A (1978) Prognostic factors in acute myocardial infarction occurring within the first five days of ECG-monitoring. Dan Med Bull 25 (4): 155–159

    Google Scholar 

  4. Pell S, D'Alonzo CA (1964) Immediate mortality and five-year survival of employed men with a first myocardial infarction. N Engl J Med 270: 916–922

    Google Scholar 

  5. Cooperative study (1966) Death rate among 795 patients in first year after myocardial infarction. J Am Med Assoc 197: 184–186

    Google Scholar 

  6. Beard OW, Hipp HR, Robins M, Taylor JS, Ebert RV, Beran, LG (1960) Initial myocardial infarction among 503 veterans. Five-year survival. Am J Med 28: 871–883

    Google Scholar 

  7. Helmers C, Lundman T, Massing R, Wester PO (1976) Mortality pattern among initial survivors of acute myocardial infarction using a life-table technique. Acta Med Scand 200: 469–473

    Google Scholar 

  8. Weinblatt E, Shapiro S, Frank CW, Sager RV (1968) Prognosis of men after first myocardial infarction: mortality and first recurrence in relation to selected parameters. Am J Public Health 58: 1329–1347

    Google Scholar 

  9. Ibrahim MA, Sackett DL, Winkelstein W Jr (1969) Acute myocardial infarction: magnitude of the problem. In: Sherry S, Brinkhous KM, Genton E, Stengle JM (eds) Thrombosis. National Academy of Sciences, Washington, DC pp 106–116

    Google Scholar 

  10. Cannom DS, Levy W, Cohen LS (1976) The short- and long-term prognosis of patients with transmural and non-transmural myocardial infarction. Am J Med 61: 452–458

    Google Scholar 

  11. Zumoff B, Hart H, Hellman L (1966) Considerations of mortality in certain chronic diseases. Ann Intern Med 64: 595–601

    Google Scholar 

  12. Helmers C, Lundman T (1978) Sudden coronary death after acute myocardial infarction. Adv Cardiol 25: 176–182

    Google Scholar 

  13. Bigger JT Jr, Heller CA, Wenger TL, Weld FM (1978) Risk stratification after acute myocardial infarction. Am J Cardiol 42: 202–210

    Google Scholar 

  14. Schulze RA Jr, Strauss HW, Pitt B (1977) Sudden death in the year following myocardial infarction. Relation to ventricular premature contractions in the late hospital phase and left ventricular ejection fraction. Am J Med 62: 192–199

    Google Scholar 

  15. Luria MH, Knoke JD, Margolis RM, Hendricks FH, Kuplic JB (1976) Acute myocardial infarction: prognosis after recovery. Ann Intern Med 85: 561–565

    Google Scholar 

  16. Moss AJ, DeCamilla J, Davis H (1977) Cardiac death in the first 6 months after myocardial infarction: potential for mortality reduction in the early posthospital period. Am J Cardiol 39: 816–820

    Google Scholar 

  17. Cardiovascular actions of sulfinpyrazone: basic and clinical research (1980). In: McGregor M, Mustard JF, Oliver M, Sherry S (eds) Proceedings of Anturane International Symposium, May 21–23. Symposia Specialists, Miami, pp 151–209

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Temple University School of Medicine, Philadelphia, USA

    S. Sherry

Authors
  1. S. Sherry
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sherry, S. Drug trials in myocardial infarction. Eur J Clin Pharmacol 17, 401–407 (1980). https://doi.org/10.1007/BF00570155

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00570155

Key words

Search

Navigation