Document Detail

Enalaprilat in acute myocardial infarction: tolerability and effects on the renin-angiotensin system.
MedLine Citation:
PMID:  1657799     Owner:  NLM     Status:  MEDLINE    
We treated 48 patients with intravenous enalaprilat within 24 hours from the onset of acute myocardial infarction. Concomitant therapy included thrombolytic treatment (29), intravenous metoprolol (34), intravenous nitroglycerin (16) and intravenous furosemide (15). The first 40 patients included had systolic blood pressure at baseline greater than or equal to 110 mmHg. Intravenous bolus injections of 0.2-1.2 mg (mean 1.0 mg) enalaprilat in one hour were given to 20 patients and an intravenous infusion of 1 mg over two hours was administered to another 20 patients, as well as to a separate group of 8 patients with systolic blood pressure between 100-109 mmHg at baseline. The infusion was stopped in five cases when the systolic blood pressure fell below 100 and 90 mmHg, respectively, in the two infusion groups. No hypotensive reactions were symptomatic. Blood pressure decreased from a mean of 134/82, 131/79 and 106/72 mmHg to a minimum of 117/71, 118/73 and 97/63 mmHg, respectively, in the three groups. Almost complete suppression of plasma angiotensin converting enzyme activity was achieved within 30 minutes. No significant changes were found in plasma levels of angiotensin II, renin activity or atrial natriuretic peptide between baseline and 24 hours. Treatment was continued with oral enalapril 2.5-10 mg/day, which was generally well tolerated. We conclude that intravenous and oral enalapril added to conventional therapy in the early phase of acute myocardial infarction is well tolerated in selected patients, but should be carefully titrated.
A Sigurdsson; P Held; G Andersson; K Swedberg
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of cardiology     Volume:  33     ISSN:  0167-5273     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  1991 Oct 
Date Detail:
Created Date:  1991-12-20     Completed Date:  1991-12-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  115-24     Citation Subset:  IM    
Department of Medicine, Ostra Hospital, University of Göteborg, Sweden.
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MeSH Terms
Blood Pressure / drug effects
Enalaprilat / administration & dosage,  therapeutic use*
Furosemide / therapeutic use
Infusions, Intravenous
Injections, Intravenous
Metoprolol / therapeutic use
Middle Aged
Myocardial Infarction / drug therapy*
Nitroglycerin / therapeutic use
Renin-Angiotensin System / drug effects*
Thrombolytic Therapy
Reg. No./Substance:
37350-58-6/Metoprolol; 54-31-9/Furosemide; 55-63-0/Nitroglycerin; 84680-54-6/Enalaprilat

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