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Biomedical subjects

T Zaleska

Publications and source records attributed to T Zaleska.

At least 19 recordsLinked to original sources
PubMed1996

Lack of effect of amiodarone on survival after extensive infarction. Polish Amiodarone Trial.

BACKGROUND: The purpose of this study was to elucidate whether the reduction of mortality with amiodarone after myocardial infarction depended on ejection fraction. METHODS: The data from the Polish Amiodarone Trial were analysed retrospectively. Patients with acute myocardial infarction and contraindications to beta-blockers were randomized on days 5-7 after admission to receive amiodarone (n = 305) or placebo (n = 308). Short and long-term (46 months) mortality were analysed comparing the groups with impaired (ejection fraction < 40%) and preserved (ejection fraction > or = 40%) left ventricular function. A subset of patients (n = 523) with available echocardiograms were subjected to this analysis. RESULTS: Long-term and sudden cardiac mortality were significantly reduced with amiodarone in the group of patients with ejection fraction > or = 40% (amiodarone versus placebo, respectively: 9.1 versus 16.5%, P < 0.05; 3.4 versus 8.2, P < 0.05). No beneficial effect of amiodarone was observed in the group with low ejection fraction (cardiac and sudden cardiac mortality: amiodarone versus placebo, 20.8 versus 19.3% and 7.8 versus 5.7% respectively). One-year mortality also revealed a favourable trend only in amiodarone-allocated patients with ejection fraction > or = 40%. CONCLUSION: Amiodarone decreased long-term and sudden cardiac mortality after myocardial infarction only in patients with preserved left ventricular function. No benefit was observed in patients with decreased ejection fraction.

Amiodarone↗
PubMed1992

Effect of amiodarone on mortality after myocardial infarction: a double-blind, placebo-controlled, pilot study.

OBJECTIVES: The goal of this study was to evaluate the effect of amiodarone on mortality, ventricular arrhythmias and clinical complications in high risk postinfarction patients. BACKGROUND: No therapy has been shown to reduce sudden death in patients ineligible to receive beta-adrenergic blocking agents after myocardial infarction. METHODS: Patients who were not eligible to receive beta-blockers were randomized to receive amiodarone (n = 305) or placebo (n = 308) for 1 year. RESULTS: There were 21 deaths in the amiodarone group compared with 33 in the placebo group (odds ratio 0.62, 95% confidence interval [CI] 0.35 to 1.08, p = 0.095). There were two noncardiac deaths in the amiodarone group and none in the placebo group; thus, the difference in cardiac mortality (19 vs. 33, respectively) was statistically significant (odds ratio 0.55, 95% CI 0.32 to 0.99, p = 0.048). There was a significant decrease in Lown class 4 ventricular arrhythmias (7.5% vs. 19.7%, respectively, p < 0.001). Adverse effects developed in 30% of amiodarone-treated patients and 10% of placebo-treated patients. Pulmonary toxicity, which was mild and reversible, occurred in only one patient in the amiodarone group but in no patient in the placebo group. CONCLUSIONS: This trial demonstrated a significant reduction in cardiac mortality and ventricular arrhythmias with amiodarone treatment. However, given the wide confidence intervals and borderline statistical significance of our trial, larger trials are needed to confirm or refute this view.

Amiodarone↗
PubMed1982

Effectiveness of clonidine in patients with angina pectoris in relation to the initial level of catecholamines in urine.

32 patients with chronic angina pectoris were given clonidine in a dose 150 microgram/day parallelly with routine coronary drugs. The aim of the study was to select the best candidates for this kind of treatment which is known to reduce sympathetic tone and consequently alleviates the severity of the disease. It has been found that clonidine produced clinical improvement predominantly in patients characterized by high initial excretion of catecholamines in urine. The beneficial effect of such treatment was parallelled by a decrease of adrenaline and noradrenaline content in urine. The results obtained have confirmed the supposition that the best candidates for clonidine therapy are individuals with highly augmented adrenergic strain.

Adult↗
PubMed1979

Clonidine effect in chronic angina pectoris. Double-blind, crossover trial on 60 patients.

Increased adrenergic activity, often manifested in chronic angina, is likely to influence adversely the course of the disease. In view of the inhibitory effect of clonidine (CL) upon the adrenergic nervous system, the effectiveness of small doses of CL in chronic angina was evaluated in a double-blind crossover study on 60 patients suffering at least 5 coronary pains per week in spite of routine medication. CL was given orally in a dose of 2 x 75 microgram/day for a 2 wk. Reduction in frequency of coronary pains by at least 50% was observed in 53.7% of patients, total nitroglycerin consumption decreased from 322 to 174 tablets/week, and ergometric performance increased from 168 to 283 W x min/patient. Urinary excretion of adrenaline and noradrenaline diminished. Blood pressure and heart rate were not considerably changed. Mild and transient side effects occurred in 10 patients, 9 of them completed the trial. It is concluded that CL in low doses is effective and safe in patients with chronic angina, presumably by alleviating adrenergic strain.

Administration, Oral↗
PubMed1979

Effects of beta-blocking agent Metipranolol on metabolic variables in patients with ischemic heart disease, hyperkinetic syndrome, hyperthyreosis and in healthy subjects.

Metabolic effects of Metipranolol, a new beta adrenergic blocking agent, have been studied in patients with ischemic heart disease, hyperkinetic syndrome, hyperthyreosis and in healthy subjects. Administration of the drug (30 mg per day for one week) resulted in the decrease of noradrenaline excretion, blood free fatty acid level, and in lowering of blood pressure and heart rate, particularly in patients with ischemic heart disease and hyperkinetic syndrome. These alterations were accompanied by alleviation of clinical symptoms. It is suggested that Metipranolol by suppressing the activity of sympathetic nervous system and thereby diminishing lypolysis, exerts favourable clinical effects, most probably related to diminution of myocardial oxygen consumption.

Adrenergic beta-Antagonists↗
PubMedDate not supplied

Efficacy and tolerance of nisoldipine VS propranolol in patients with essential hypertension.

Fifty patients with essential hypertension grade I/II. (WHO) were treated with Nisoldipine (BAY K 5552) or Propranolol for 12 weeks in a single blind, randomised trial. Both drugs similarly reduced mean systolic and diastolic blood pressure. Side effects were rare and usually mild. We conclude that Nisoldipine is safe and effective in the treatment of mild essential hypertension.

Blood Pressure↗