tailieunhanh - Báo cáo khoa học: " Nitric oxide inhibition rapidly increases blood pressure with no change in outcome in cardiogenic shock: the TRIUMPH trial"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Nitric oxide inhibition rapidly increases blood pressure with no change in outcome in cardiogenic shock: the TRIUMPH trial. | Available online http content 11 3 136 Commentary Nitric oxide inhibition rapidly increases blood pressure with no change in outcome in cardiogenic shock the TRIUMPH trial Réda Salem1 and Alexandre Mebazaa2 1 Département de Cardiologie Centre Hospitalier de l université de Montréal 3840 rue Saint-Urbain Montréal Québec H2W 1T8 Canada 2Département d Anesthésie-Réanimation Hôpital Lariboisiere AP-HP Université Paris 7 Diderot Paris 2 Rue A Paré 75475 Paris Cedex 10 France Corresponding author Alexandre Mebazaa Published 7 June 2007 Critical Care 2007 11 136 doi cc5925 This article is online at http content 11 3 136 2007 BioMed Central Ltd Abstract The TRIUMPH study recently published in Journal of the American Medical Association was a prospective randomized placebo-controlled trial testing the hypothesis that tilarginine a non-specific inhibitor of nitric oxide synthase when compared with placebo would reduce 30-day mortality by 25 in patients with myocardial infarction complicated by refractory cardiogenic shock despite successful revascularization of the infarct-related artery. Patients received an intravenous bolus of the drug followed by 5 hours of intravenous infusion of the drug or a matching placebo. Although tilarginine increased systolic blood pressure by 5 mmHg at 2 hours no effect on mortality was observed at 30 days. There was however a 6 absolute increase in 30-day mortality in the tilarginine group 48 versus 42 in the placebo . This definitive trial gave strong indications for stopping any further trial using nonspecific inhibitors of nitric oxide synthase in cardiogenic shock and possibly also in any other cardiovascular area. The results of the latest large trial in patients with cardiogenic shock CS namely the TRIUMPH trial were recently published in Journal of the American Medical Association 1 . About 6 to 9 of myocardial infarctions MIs mostly with ST elevation is complicated by CS .