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GISSI-3 trial

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

19394 patients who presented within 24 hr of the onset of symptoms of acute myocardial infarction were randomised to:

  • 6 weeks oral lisinopril vs. open control
  • nitrates (i.v. then transdermal) vs. open control

Other treatments, such as aspirin, beta-blockers and thrombolytics, were administered as clinically indicated.

Lisinopril was found to significantly reduce:

  • overall mortality at 6 weeks (odds ratio = 0.88)
  • severe ventricular dysfunction (odds ratio = 0.90)

Nitrates alone did not have a significant effect.

The combination of nitrates and lisinopril was slightly better than lisinopril alone in reducing:

  • overall mortality at 6 weeks (odds ratio = 0.83)
  • severe ventricular dysfunction (odds ratio = 0.85)

Reference:

  • GISSI-3: effects of lisinopril and transdermal glyceryl trinitrate singly and together on 6-week mortality and ventricular function after acute myocardial infarction. (1994). Lancet, 343, 1115-22.
  • Eisenberg PR (1996). Early treatment with lisinopril for 6 weeks reduced mortality at 6 months in acute MI. EBM, 1 (5), 139.

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