{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T07:16:29Z","timestamp":1765178189355,"version":"3.44.0"},"reference-count":26,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:00Z","timestamp":1705017600000},"content-version":"unspecified","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Clinical Research from Miyazaki University Hospital","award":["31012614"],"award-info":[{"award-number":["31012614"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2023,11,27]]},"published-print":{"date-parts":[[2024,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The primary care for acute coronary syndrome (ACS) includes the administration of nitroglycerin (GTN). This study aimed to investigate the association between the use of GTN before percutaneous coronary intervention (PCI) for ACS and clinical outcomes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Nine-hundred and forty-seven patients who underwent PCI for ACS were examined and classified into two groups: those who were treated with GTN before PCI (GTN group) and those who were not (non-GTN group). The incidence of major adverse cardiovascular events (MACE), which consist of all-cause mortality, non-fatal myocardial infarction, stroke and rehospitalisation for heart failure at 1\u2009year, was compared between the two groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>This study identified 289 patients with ACS who used GTN preceding PCI. Pre-PCI systolic blood pressure was significantly lower in the GTN group than in the non-GTN group (median (IQR); 132.0 (110.0\u2013143.5)\u2009mm Hg vs 134.0 (112.0\u2013157.0)\u2009mm Hg, respectively, p=0.03). Multivariate Cox regression analysis indicated that GTN use preceding PCI showed an independent association with the incidence of MACE (HR 1.57; 95% CI 1.09\u20132.28; p=0.016). Overall, the incidence of MACE 1\u2009year after PCI for ACS was significantly higher in the GTN group than in the non-GTN group (log-rank test, p=0.024); however, this trend was consistently found in elderly patients aged \u226575 years (p=0.002) but not in non-elderly patients aged &lt;75 years (p=0.773).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>GTN use preceding PCI for ACS is associated with lower blood pressure and adverse clinical outcomes in elderly patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2023-002494","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T00:00:48Z","timestamp":1705017648000},"page":"e002494","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Nitroglycerin use and adverse clinical outcomes in elderly patients with acute coronary syndrome"],"prefix":"10.1136","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4946-2313","authenticated-orcid":false,"given":"Soichi","family":"Komaki","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan"},{"name":"Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Miyazaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yunosuke","family":"Matsuura","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroki","family":"Tanaka","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kohei","family":"Moribayashi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshimasa","family":"Yamamura","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazumasa","family":"Kurogi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Miyazaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Ideguchi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nobuyasu","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Miyazaki Prefectural Nobeoka Hospital, Nobeoka, Miyazaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michikazu","family":"Nakai","sequence":"additional","affiliation":[{"name":"Clinical Research Support Center, University of Miyazaki Hospital, Miyazaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Toshihiro","family":"Tsuruda","sequence":"additional","affiliation":[{"name":"Department of Hemo-Vascular Advanced Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koichi","family":"Kaikita","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Miyazaki, 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