| Pretreatment with intracoronary enalaprilat protects human myocardium during percutaneous coronary angioplasty. | |
MedLine Citation:
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PMID: 17433950 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We tested the hypothesis that enalaprilat induces preconditioning (PC)-mimetic actions in patients with stable coronary artery disease. BACKGROUND: Angiotensin-converting enzyme (ACE) inhibitors increase the bioavailability of bradykinin, which induces cardiac PC. METHODS: Twenty-two patients undergoing coronary angioplasty were randomized to an intracoronary infusion of enalaprilat or placebo, followed 10 min later by a PC protocol. RESULTS: In control patients, the ST-segment shift was greater during the first inflation than during the second and third inflations, both on the intracoronary electrocardiogram (ECG) (21.0 +/- 2.8 mm vs. 13.0 +/- 2.0 mm and 13.0 +/- 2.0 mm, p < 0.05) and the surface ECG (16.0 +/- 4.0 mm vs. 10.0 +/- 2.0 mm and 9.0 +/- 2.0 mm, p < 0.05). In contrast, enalaprilat-pretreated patients showed no change in ST-segment shift during inflations on either the intracoronary or the surface ECG. During the first inflation, the ST-segment shift was significantly smaller in treated versus control patients. The chest pain score during the first inflation was also significantly smaller in treated patients versus control patients (33.0 +/- 6.0 mm vs. 64.0 +/- 6.0 mm) and did not change in treated patients during the second and third inflations, whereas it decreased significantly in control patients. In a subset of 6 patients, enalaprilat increased coronary blood flow during infusion, but this effect dissipated before the beginning of angioplasty. CONCLUSIONS: Pretreatment with enalaprilat attenuates the manifestations of myocardial ischemia during angioplasty. This is the first in vivo evidence showing that an ACE inhibitor protects human myocardium, possibly via PC-mimetics actions, a novel property that might explain the cardioprotective actions of these drugs. |
Authors:
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Massoud A Leesar; Hani Jneid; Xian-Liang Tang; Roberto Bolli |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2007-04-02 |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 49 ISSN: 1558-3597 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 2007 Apr |
Date Detail:
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Created Date: 2007-04-16 Completed Date: 2007-05-01 Revised Date: 2007-12-03 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1607-10 Citation Subset: AIM; IM |
Affiliation:
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Division of Cardiology, University of Louisville, Louisville, Kentucky 40292, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angina Pectoris
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diagnosis*,
drug therapy*,
therapy Angioplasty, Transluminal, Percutaneous Coronary / methods* Angiotensin-Converting Enzyme Inhibitors / administration & dosage* Chi-Square Distribution Chronic Disease Coronary Angiography Coronary Circulation / drug effects Electrocardiography Enalaprilat / administration & dosage* Female Follow-Up Studies Humans Infusions, Intralesional Ischemic Preconditioning, Myocardial / methods Male Middle Aged Probability Reference Values Risk Assessment Severity of Illness Index Treatment Outcome Vascular Patency / drug effects |
| Grant Support | |
ID/Acronym/Agency:
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HL-55757/HL/NHLBI NIH HHS; HL-68088/HL/NHLBI NIH HHS; HL-70897/HL/NHLBI NIH HHS; HL-76794/HL/NHLBI NIH HHS; HL-78825/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors; 84680-54-6/Enalaprilat |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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