[Lack of tolerance development with low dose nitrate administration in acute myocardial infarct]

Reports on the development of tolerance have modified the use of nitrates in the treatment of coronary heart disease. Dosage limitations and nitrate-free intervals are frequently recommended to solve this problem (4, 5). In the clinical setting of acute myocardial infarction continuous application of glyceryl trinitrate (GTN) is still a widely used therapy (1). In this study we investigated whether a low-dose intravenous GTN administration leads to a rapid development of tolerance. During the observation period of 60 h, no attenuation of drug effects on the pulmonary pressures could be detected. Subsequent oral medication also showed an undiminished nitrate response.