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Reduction in Q wave myocardial infarctions with gemfibrozil in the Helsinki Heart Study
M Mänttäri1, M Romo, V Manninen
1First Department of Medicine, Helsinki University Central Hospital, Finland.
Insights
Gemfibrozil significantly reduced cardiac events in men with dyslipidemia, primarily nonfatal myocardial infarctions. Further analysis showed a 45% decrease in Q wave myocardial infarctions with gemfibrozil treatment.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Background:
- Dyslipidemia is a significant risk factor for cardiovascular disease.
- The Helsinki Heart Study previously showed gemfibrozil reduced cardiac endpoints in dyslipidemic men.
- Different types of myocardial infarction may have distinct prognoses.
Purpose of the Study:
- To investigate the specific effects of gemfibrozil on Q wave and non-Q wave myocardial infarctions.
- To determine if gemfibrozil's benefit on cardiac events is linked to a specific infarction type.
Main Methods:
- Analysis of data from the Helsinki Heart Study.
- Comparison of gemfibrozil therapy versus placebo in middle-aged men with dyslipidemia.
- Stratification of myocardial infarctions into Q wave and non-Q wave types.
Main Results:
- Gemfibrozil therapy resulted in a 45% reduction in the cumulative incidence of Q wave myocardial infarctions (p < 0.02).
- No statistically significant effect was observed on the incidence of non-Q wave myocardial infarctions.
- The reduction in Q wave infarctions became apparent in the latter half of the 5-year study period.
Conclusions:
- Gemfibrozil therapy specifically reduces the incidence of Q wave myocardial infarctions in dyslipidemic men.
- The cardioprotective effect of gemfibrozil may be attributed to its impact on Q wave infarction development.
- Further research may elucidate the mechanisms behind this specific effect.
Abstract:
The Helsinki Heart Study demonstrated a 34% (p less than 0.02) reduction in the incidence of cardiac end points (myocardial infarction and cardiac death) with the use of gemfibrozil compared with the use of a placebo in dyslipidemic middle-aged men. The major effect was confined to nonfatal myocardial infarctions. In this study we analyzed the effect of gemfibrozil therapy on the incidences of Q wave and non-Q wave infarctions, since the long-term prognoses of these two types of myocardial infarction may be different. The analyses indicated a 45% reduction (P less than 0.02, log-rank test) in the cumulative incidence of Q wave infarctions in the gemfibrozil group without a statistically significant effect on either the rate of non-Q wave infarctions or of coronary deaths. The reduction in the incidence of Q wave infarctions became evident during the second half of the 5-year study period.