Document Detail


Maximizing benefits of therapies in acute myocardial infarction.
MedLine Citation:
PMID:  8279352     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Major advances in the management of acute myocardial infarction have been achieved by a combination of careful experimental work and development of effective pharmacologic and interventional strategies in conjunction with the conduct of large, reliable randomized trials. Current trials indicate that a combination of thrombolytic therapy, aspirin, and intravenous followed by oral beta blockers reduces mortality. There are a number of additional promising interventions, such as intravenous magnesium, nitrates, and the newer antithrombin agents. However, before these agents are used widely in clinical practice, clear proof of benefit and adequate safety should be available from the ongoing randomized trials. Following discharge from the hospital, long-term therapy with aspirin and beta blockers should be considered in all patients. In patients with heart failure and low ejection fraction, angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce mortality, reinfarction, and the need for further hospitalizations for heart failure. Therefore, these therapies, in conjunction with risk factor modification (cessation of cigarette smoking, treatment of hypercholesterolemia, treatment of hypertension), should be considered in all appropriate patients. A number of new strategies for the prevention of atherosclerosis and its complications are currently being evaluated in prospective randomized trials. These include the natural antioxidant vitamins, estrogen replacement therapy, tamoxifen therapy, and ACE inhibitors in patients without evidence of heart failure or left ventricular dysfunction.
Authors:
C Le Feuvre; S Yusuf; M Flather; M Farkouh
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:  145G-155G     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiology, McMaster University, Hamilton General Hospital, Ontario, Canada.
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MeSH Terms
Descriptor/Qualifier:
Humans
Myocardial Infarction / drug therapy,  therapy*
Myocardial Reperfusion
Randomized Controlled Trials as Topic
Thrombolytic Therapy / methods*
Treatment Outcome

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


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