Document Detail


Early and late angiotensin-converting enzyme inhibition in acute myocardial infarction.
MedLine Citation:
PMID:  8279354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Studies in animals and humans have shown that angiotensin-converting enzyme (ACE) inhibitors can prevent or at least attenuate ventricular dilation and remodeling following acute myocardial infarction (MI) and can improve subsequent left ventricular dysfunction, a strong predictor of survival. The question as to which patients will benefit most from ACE inhibitor therapy and the optimal timing of administration of such intervention after the onset of symptoms is still matter of debate, even if it is hypothesized that a greater benefit in terms of remodeling prevention may occur after early administration. However, while it is currently accepted that patients with asymptomatic postinfarctual left ventricular dysfunction can benefit from long-term administration of an ACE inhibitor when therapy is started late, the usefulness of an early administration is still to be clarified. In this setting, the question of early versus late ACE inhibitor treatment has to be related to the different evolving pattern of myocardial infarction with regard to the different degrees of postinfarction ventricular dysfunction and neurohormonal activation, whose extent could influence the effect of ACE inhibition. For example, not all patients with acute MI show progressive ventricular dilation. Early dilation is frequent in patients with anterior localization of necrosis, whereas it is usually not relevant in patients with acute inferior MI. Thus, different postinfarction patterns may differently influence the clinical success of therapeutic interventions, which can be instituted at various stages following acute MI.(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
C Borghi; S Bacchelli; D Degli Esposti; E Ambrosioni
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The American journal of cardiology     Volume:  72     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1993 Dec 
Date Detail:
Created Date:  1994-02-04     Completed Date:  1994-02-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  169G-174G     Citation Subset:  AIM; IM    
Affiliation:
Clinica Medica III, University of Bologna, Italy.
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MeSH Terms
Descriptor/Qualifier:
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Animals
Clinical Trials as Topic
Humans
Myocardial Infarction / drug therapy*
Time Factors
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors

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