Document Detail

Comparison of enalapril versus captopril on left ventricular function and survival three months after acute myocardial infarction (the "PRACTICAL" study).
MedLine Citation:
PMID:  8203335     Owner:  NLM     Status:  MEDLINE    
Left ventricular (LV) function and survival can be improved with captopril when initiated later than 24 hours after acute myocardial infarction. Animal studies suggest additional benefits may be obtained with earlier initiation of angiotensin-converting enzyme (ACE) inhibitors. The effects on LV function of captopril and enalapril initiated within 24 hours of myocardial infarction were studied. Two hundred twenty-five patients with acute myocardial infarction were enrolled within 24 hours of the onset of chest pain. They were randomized to receive either captopril 25 mg three times daily, enalapril 5 mg three times daily, or placebo. LV ejection fraction (EF) and volumes were measured by radionuclide ventriculography at baseline during treatment and at 3 months after a 3-day withdrawal from therapy. The ACE inhibitor group had a significant increase in EF (45 +/- 1 to 47 +/- 1%; p = 0.005) and significantly attenuated LV dilatation compared with results in the placebo group (175 +/- 6 to 189 +/- 7 ml in the placebo group vs 168 +/- 4 to 172 +/- 4 ml in the ACE inhibitor group; p = 0.051 for LV end-diastolic volume; and 99 +/- 6 to 108 +/- 7 ml in the placebo group vs 94 +/- 3 to 94 +/- 4 ml; p = 0.026 for LV end-systolic volume). The beneficial effects of ACE inhibitor therapy on LV function were observed irrespective of the degree of initial LV dysfunction and were comparable in both the captopril and enalapril groups.(ABSTRACT TRUNCATED AT 250 WORDS)
S G Foy; I G Crozier; J G Turner; A M Richards; C M Frampton; M G Nicholls; H Ikram
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of cardiology     Volume:  73     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1994 Jun 
Date Detail:
Created Date:  1994-07-07     Completed Date:  1994-07-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1180-6     Citation Subset:  AIM; IM    
Department of Cardiology, Princess Margaret Hospital, Christchurch, New Zealand.
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MeSH Terms
Angiotensin II / blood
Blood Pressure / drug effects
Captopril / administration & dosage,  adverse effects,  therapeutic use*
Cardiac Volume / drug effects
Cause of Death
Double-Blind Method
Drug Tolerance
Enalapril / administration & dosage,  adverse effects,  therapeutic use*
Follow-Up Studies
Gated Blood-Pool Imaging
Middle Aged
Myocardial Infarction / drug therapy*,  physiopathology,  radionuclide imaging
Stroke Volume / drug effects
Survival Rate
Ventricular Function, Left / drug effects*
Reg. No./Substance:
0/Placebos; 11128-99-7/Angiotensin II; 62571-86-2/Captopril; 75847-73-3/Enalapril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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