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[Interaction between antiplatelet agents and angiotensin-converting enzyme inhibitors]
1Serviço de Cardiologia da Faculdade de Medicina da Universidade do Porto, Serviço de Cardiologia do Hospital de S. João, Unidade de Investigação e Desenvolvimento Cardiovascular do Porto.
Abstract:
The use of angiotensin converting enzyme inhibitors (ACEIs), as well as of acetyl salicylic acid (ASA) in patients with hypertension, myocardial infarction or heart failure is recommended by the guidelines issued by several respected cardiological societies. However, some authors have argued that ASA may decrease the effectiveness of ACEIs by decreasing the release of prostagandins. Although such negative interaction is still not conclusively demonstrated, the merits of the use of this association should be judged in each individual patient with heart failure. It seems prudent to use low doses of ASA (< or = 250 mg/day) in these patients. ADP antagonists may constitute an alternative to ASA since they do not block prostaglandin synthesis.