Effects of Two Different ACE Inhibitors, Captopril and Delapril, in the Early Phases of Acute Anterior Myocardial Infarction

Objective: This study was aimed at investigating the effects of captopril or delapril before and just after thrombolysis in acute anterior myocardial infarction (AMI). Patients and Methods: Study participants consisted of 89 patients, hospitalised within 4 hours of the onset of symptoms. Patients were randomly divided into two groups: the first group (45 patients, pretreatment group) received captopril 6.25mg or delapril 7.5mg orally about 15 minutes before intravenous administration of recombinant tissue plasminogen activator (rt-PA) 100mg; the second group (44 patients, late-treatment group) received captopril or delapril about 4 to 6 hours after thrombolytic treatment. Captopril/delapril…

Effects of the Combination of Candesartan plus Captopril in Elderly Patients with Anterior Myocardial Infarction

Objective: To verify the feasibility, tolerability and efficacy of the combination of captopril (75 mg/day) and candesartan (8 mg/day) in early postinfarction phases of not thrombolysed and unreperfused anterior acute myocardial infarction (AMI) in elderly patients. Design and Patients: 71 patients (aged >65 years) hospitalised for anterior AMI were randomised in a double-blind manner into two groups: group A included 35 patients who received captopril 75 mg/day within 3 days of admission plus candesartan 4mg, as a first dose, and 8 mg/day successively; group B included 36 patients who received captopril 75 mg/day and placebo. 90 days after admission, patients underwent echocardiography to …

415 Does angiotensin-converting enzyme I/D polymorphism afect blood pressure and diastolic function? Findings after six years of follow up in healthy subjects

Use of bivalirudin for heparin-induced thrombocytopaenia after thrombolysis in massive pulmonary embolism: a case report

A 68-year-old man was referred to the emergency department 6 h after onset of sudden acute dyspnoea. Immediate ECG showed sinus tachycardia with the typical S1-Q3-T3 pattern and incomplete right bundle branch block. The echocardiogram showed the presence of mobile thrombus in the right atrium, a distended right ventricle with free wall hypokinesia and displacement of the interventricular septum towards the left ventricle. Lung spiral computed tomography (CT) showed bilateral pulmonary involvement and confirmed the picture of a thrombotic system in the right atrium and caval vein. Thrombolytic treatment with recombinant tissue plasminogen activator (rt-PA) and heparin (alteplase 10 mg bolus,…

Safety and tolerability of abciximab in patients with acute myocardial infarction and failed thrombolysis.

Abstract Aim: The aim of this study was to evaluate glycoprotein IIb/IIIa receptor inhibitor effectiveness in AMI patients with unsuccessful thrombolysis. Methods: Eighty-four patients hospitalised within 4 h of symptom onset were randomised (single blind) into two groups. Regardless of the group, placebo or GP IIb/IIIa inhibitors were administered to patients who did not present with reperfusion signs 30 min after starting thrombolysis and 30–60 min after the end of full thrombolysis in patients with pain recurrence and ST-segment elevation. Reperfusion was assessed by the creatine kinase peak occurring within 12 h, by the observation of rapid ST-segment reduction (50–70% within 1 h) in 12…

Relationship between ACE-DD polymorphism and diastolic performance in healthy subjects.

Background—The ACE-D allele has been associated with cardiovascular disease. The study evaluates the relationship between the ACE-ID genotypes and diastolic function in healthy subjects after 6 years of follow-up. Methods—Two hundred and seventy-five healthy volunteers aged 25–55 years had normal physical examination, 12-lead ECG, acceptable echocardiographic windows and echocardiogram at entry. Venous blood was drawn for DNA analysis. Results—Two hundred and forty-two subjects completed 6 years of follow-up. Three genetically distinct groups were obtained: ACE-DD group (n=71, 26F/45M, mean age 48±7 years); ACE-ID (n=115, 39F/76M, mean age 40±7 years); and ACE-II (n=56, 20F/36M, mean age 47…

Angiotensin-converting enzyme gene deletion polymorphism determines an increase in frequency of migraine attacks in patients suffering from migraine without aura.

Many authors have reported an association between the angiotensin-converting enzyme (ACE)-D allele and coronary heart disease and other cardiovascular diseases. The mechanism underlying the positive associations between the ACE-D alleles and diseases are not yet clear. Previous reports showed an association between migraine without aura and ACE-D allele polymorphism. The study is aimed to evaluate if the DD genotype could also be associated with the frequency and duration of migraine without aura. In 302 patients suffering from migraine without aura (at least for 1 year), with no history of cardiovascular diseases and major risk factors for ischemic events, the genotypes of the ACE gene, pl…

Effects of high-dose furosemide and small-volume hypertonic saline solution infusion in comparison with a high dose of furosemide as a bolus, in refractory congestive heart failure

Background: Diuretics, have been accepted as first-line treatment in refractory heart failure, but a lack of response is a frequent event. A randomised single blind study was performed to evaluate the effects of the combination of high-dose furosemide and small-volume hypertonic saline solution (HSS) infusion in the treatment of refractory NYHA class IV congestive heart failure (CHF). Materials and methods: Sixty patients (21 F/39 M) with refractory CHF (NYHA class IV) of different etiologies, unresponsive to high oral doses of furosemide, ACE-inhibitors, digitalis, and nitrates, aged 65–90 years, were enrolled. They had to have an ejection fraction (EF) < 35%, serum creatinine < 2 mg/dl, B…