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[Converting enzyme inhibitors in acute myocardial infarct and heart failure]
1Klinika za bolesti srca i reumatizam, Klinicki centar Sarajevo.
Insights
Angiotensin converting enzyme (ACE) inhibitors reduce heart failure after myocardial infarction. Early administration of lisinopril in coronary care units significantly decreased postinfarction heart failure rates.
Area of Science:
- Cardiology
- Pharmacology
Context:
- ACE inhibitors have been used for over 15 years to treat hypertension, heart failure, myocardial infarction, and diabetic nephropathy.
- Their efficacy stems from reducing angiotensin II and potentiating kinins, improving cardiac function and preventing hypertrophy.
Purpose:
- To evaluate the impact of early ACE inhibitor therapy on postinfarction heart failure.
- To assess the effectiveness of lisinopril in patients admitted to the Coronary Care Unit.
Summary:
- ACE inhibitors were introduced into clinical practice in 1987.
- Lisinopril was administered to 70% of 2855 Coronary Care Unit patients in 1997-1998, alongside standard therapies.
- A decrease in postinfarction heart failure was observed compared to previous years.
Impact:
- Early ACE inhibitor therapy, specifically with lisinopril, is associated with reduced postinfarction heart failure.
- Permanent low-dose ACE inhibitor therapy is recommended for patients with heart infarction.
Abstract:
Inhibitors of angiotensin converting enzyme (ACE inhibitors) have been introduced more than fifteen years ago into the treatment of hypertension, congestive heart failure, myocardial infarction and diabetic nephropathy. The therapeutic success is related to their action in reduction of plasma and tissue angiotensin II concentrations and potentiation of endogenous kinins. They are able to improve myocardium metabolic status, prevent cardiac hypertrophy, limit myocardial infarct size, and thus prevent heart failure. Since 1987 ACE inhibitors are introduced in the clinical practice in our clinic. We introduced the therapy with lisinopril (Lopril), in 70% of patients among 2855 patients that were admitted in Coronary Care Unit in 1997 and 1998. Lisinopril was introduced as soon as the patient was admitted, together with fibrinolitic, Heparin and Aspirin therapy. Since that time we noticed decrease in postinfarction heart failure in comparison to previous years. We recommend permanent therapy with a small doses of ACE inhibitors in patients with heart infarction.