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Cited by 22Acute Myocardial Infarction ResearchCardiac Arrest and ResuscitationCardiac Ischemia and Reperfusion

The DOI matches its Crossref record; 28 of the 28 references it cites were found in a registry or an index.

Safety and Effectiveness of Field Nitroglycerin in Patients with Suspected ST Elevation Myocardial Infarction

Bosson, Nichole, Isakson, Benjamin, Morgan, Jayson A., Kaji, Amy H., Uner, Atilla, Hurley, Katherine, Henry, Timothy D., Niemann, James T.·2019·Prehospital Emergency Care
DOI 10.1080/10903127.2018.1558318
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Abstract

Objective: While widely used in the treatment of cardiac conditions, only limited data characterize out-of-hospital nitroglycerin (NTG) use. We sought to determine the safety of out-of-hospital sublingual NTG administered for suspected ST-segment elevation myocardial infarction (STEMI) and its effect on the patient's pain score. Methods: We prospectively identified adult patients with suspected STEMI transported by paramedics to three percutaneous Coronary Intervention PCI-capable hospitals in a large urban-suburban emergency medical services (EMS) system. We compared patients who received field NTG to those who did not. The primary outcome was the change in systolic blood pressure (SBP) between initial EMS measurement and emergency department (ED) triage vital signs. Secondary outcomes included the frequency of hypotension (SBP < 100 mmHg) and bradycardia (HR < 60) on ED arrival, drop in SBP ≥ 30 mmHg, out-of-hospital cardiac arrest (OHCA), and the change in pain score compared to an a priori threshold of −1.39. Results: Among 940 EMS transports for suspected STEMI, we excluded 160 for initial SBP < 100 mmHg, leaving 780 subjects for the analysis. Median age was 67 with 61% male. NTG was administered to 340 (44%) patients. The median change in SBP was −10 mmHg (IQR −27, 2) and −3 mmHg (IQR −20, 9) in patients treated with and without NTG, respectively. The median difference in the decrease in SBP was 6 mmHg (95% CI 3, 9 mmHg). The frequencies of ED hypotension and bradycardia, the drop in SBP ≥ 30 mmHg, and the OHCA did not differ between groups. For patients with an initial pain score > 0, the average change in pain score for patients treated with NTG was −2.6 (95% CI −3.0, −2.2), while patients who did not receive NTG had a change in pain score of −1.4 (95% CI −1.8, −1.0). Conclusion: In this cohort, field NTG did not result in a clinically significant decrease in blood pressure when compared with patients who did not receive NTG. However, NTG did cause a clinically significant reduction in pain.

Overview

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Crossref · 10.1080/10903127.2018.1558318

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28 of 28 references verified0 citation errors · 0 not checkable

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Research works printed but not linked: 2

  1. Shah SP, 2013, Tex Heart Inst J, 40, 484
  2. 10.1001/jama.1982.03320320028025 · DOI

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Metadata

Authors
Bosson, N., Isakson, B., Morgan, J. A., Kaji, A. H., Uner, A., Hurley, K., Henry, T. D., & Niemann, J. T.
Corresponding author
Bosson, Nichole
ORCID
Venue
Prehospital Emergency Care
Publisher
Informa UK Limited
Published
2019-01-28
Volume
23
Issue
5
Pages
603-611
ISSN
  • 1090-3127 (ISSN-L)
  • 1545-0066
DOI
10.1080/10903127.2018.1558318
OpenAlex
W2903619410
Cited by
22
References
28
Citations by year
2026: 3 · 2025: 2 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 4
FWCI
0.77
Type
journal article
Language
en
Open access
closed
Locations
  • Prehospital Emergency Care (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
  • Health Sciences › Medicine › Emergency Medicine › Cardiac Arrest and Resuscitation
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Ischemia and Reperfusion
Keywords
nitroglycerin, sublingual nitroglycerin, ST-elevation myocardial infarction, prehospital care, emergency medical services, systolic blood pressure, hypotension, bradycardia, out-of-hospital cardiac arrest, drug safety, percutaneous coronary intervention, prehospital pain management
MeSH terms
ST Elevation Myocardial Infarction, Adult, Aged, Aged, 80 and over, Blood Pressure, Emergency Medical Services, Emergency Service, Hospital, Female, Nitroglycerin, Humans, Hypotension, Male, Middle Aged, Retrospective Studies, Triage, Vasodilator Agents, Percutaneous Coronary Intervention

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