Abstract
60 patients who had had a first attack of myocardial infarction entered a trial to assess the effects of phenformin plus ethylœstrenol on blood fibrinolytic activity, plasma-fibrinogen levels, and serum-cholesterol levels, together with any possible side-effects. Treatment was given for 36 lunar months. Excluding deaths and withdrawals, 42 patients completed the trial. In all but 1 of the patients with low fibrinolytic activity the treatment brought and maintained this measurement to within the normal range. Plasma-fibrinogen levels were reduced in most patients, particularly in those in whom this measurement was high. The effect on serum-cholesterol was unremarkable. The overall mortality-rate was about 7% per annum, but the rate of new non-fatal infarctions was low (4% per annum). Except for 1 patient who developed folic-acid deficiency, the side-effects of phenformin were negligible. Ethylœstrenol tended to potentiate retention of sodium in patients with badly damaged left ventricles, but in nearly all this could be controlled by an oral diuretic. This combination of drugs seems suitable for a controlled trial in survivors of vascular accidents.
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