Document Detail


The revised role of ACE-inhibition after myocardial infarction in the thrombolytic/primary PCI era.
MedLine Citation:
PMID:  15803434     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Many studies have investigated the process of left ventricular (LV) dilatation and the effects of angiotensin-converting enzyme (ACE) inhibitors after myocardial infarction (MI). It has been generally accepted that progression of LV dilatation is a major predictor of heart failure and death after MI. Also, attenuation of LV dilatation is thought to be one of the main mechanisms by which ACE inhibitors (ACE-Is) produce their beneficial effects. However, evidence for this hypothesis came from studies that were performed before thrombolytic therapy and primary percutaneous coronary intervention (PCI) were routinely used after acute MI. Nowadays, reperfusion is obtained much more frequently and LV dilatation after MI has become less prevalent. Nevertheless, ACE-Is proved effective in reducing cardiac morbidity and mortality. Therefore, mechanisms other than attenuation of LV dilatation, such as anti-atherosclerotic effects or plaque stabilisation, may explain the long-term beneficial effects of ACE-Is after MI. In the present overview, we evaluate the role of LV dilatation and the effects of ACE-Is after MI in the thrombolytic/primary PCI era and provide recommendations on ACE-I use in clinical practice.
Authors:
Pieter J de Kam; Adriaan A Voors; Francesco Fici; Dirk J van Veldhuisen; Wiek H van Gilst
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of the renin-angiotensin-aldosterone system : JRAAS     Volume:  5     ISSN:  1470-3203     ISO Abbreviation:  J Renin Angiotensin Aldosterone Syst     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2005-04-01     Completed Date:  2005-06-20     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  100971636     Medline TA:  J Renin Angiotensin Aldosterone Syst     Country:  England    
Other Details:
Languages:  eng     Pagination:  161-8     Citation Subset:  IM    
Affiliation:
Organon, Oss, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary*
Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
Fibrinolytic Agents / therapeutic use*
Humans
Myocardial Infarction / drug therapy,  therapy*
Chemical
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Fibrinolytic Agents

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


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