6533b7defe1ef96bd1275d91

RESEARCH PRODUCT

Effects of canrenoate plus angiotensin-converting enzyme inhibitors versus angiotensin-converting enzyme inhibitors alone on systolic and diastolic function in patients with acute anterior myocardial infarction

Salvatore PaternaPietro Di PasqualeAntonio FattaSergio CannizzaroSergio FasulloFrancesco GiambancoSebastiano ScalzoGaspare Parrinello

subject

Malemedicine.medical_specialtyAngiotensin-Converting Enzyme Inhibitors Mineralocorticoid Receptor Antagonists/administration & dosage Myocardial Contraction/drug effects Myocardial Infarction/drug therapy Myocardial Infarction/physiopathologymedicine.drug_classMyocardial InfarctionDiastoleAngiotensin-Converting Enzyme InhibitorsPlacebochemistry.chemical_compoundDouble-Blind MethodInternal medicinemedicineHumansMineralocorticoid Receptor AntagonistsCreatinineAldosteronebiologybusiness.industryCaptoprilAngiotensin-converting enzymeMiddle AgedMyocardial ContractionchemistryTolerabilityMineralocorticoidCardiologybiology.proteinDrug Therapy CombinationFemaleCanrenoic AcidCardiology and Cardiovascular MedicinebusinessFollow-Up Studiesmedicine.drug

description

Background Aldosterone (ALDO) exerts profibrotic effects, acting via the mineralocorticoid receptors in cardiovascular tissues. Aldosterone antagonism in combination with angiotensin-converting enzyme inhibition may better protect against the untoward effects of ALDO than angiotensin-converting enzyme inhibition alone. Methods In a double-blind randomized study, the tolerability and efficacy of canrenoate (25 mg/d) plus captopril versus captopril alone were evaluated in 510 patients with an acute anterior myocardial infarction (MI), a serum creatinine concentration 5.5 mEq/L and creatinine levels to >2.0 mg/L after 10 days of treatment were observed. At 180 days, the mitral E-wave–A-wave ratio was higher (P = .0001) and left ventricular end-systolic volume was smaller (P = .0001) in patients treated with canrenoate than in those receiving placebo. No further side effects were observed during the study period. Conclusions Our data suggest that the combination of captopril plus canrenoate is well tolerated after an acute MI and has beneficial effect on systolic and diastolic parameters and may decrease post-MI remodeling.

yearjournalcountryeditionlanguage
2004-12-30American Heart Journal
https://doi.org/10.1016/j.ahj.2005.03.032