La Biblioteca Nacional de Medicina: IGM el Registro Lleno Resguarda
EL TITULO:
Los efectos de captopril sobre ischemic sucesos despu�s de myocardial infarction. Los resultados de la Supervivencia y ensayo Ventricular de Ampliaci�n. AHORRE Investigadores.
LOS AUTORES:
Rutherford JD; Pfeffer MA; Moye LA; Davis BR; Flaker GC; Kowey PR; Lamas GA; Molinero HS; Empacador M; Rouleau JL; et al
LA AFILIACION DE AUTOR:
El departamento de Medicina, Brigham y Hospital de Mujeres, Harvard de facultad de medicina, Boston, Masa.
LA FUENTE:
La circulaci�n 1994 Oct;90(4):1731-8
LA CITACION IDS:
PMID: 7923656 UI: 95008096
ABSTRAIGA:
LOS ANTECEDENTES: En la Supervivencia y la Ampliaci�n ventricular (AHORRA) ensayo, recurrente myocardial infarction (MI) era el m�s importante predictor de un resultado pobre y conferida un sevenfold el aumento en el riesgo de muerte. El prop�sito de este estudio estuvo para determinar el predictors de MI recurrente en participantes de estudio y para examinar la influencia del angiotensin-converti el inhibidor de enzima captopril sobre este y otro myocardial ischemic sucesos. LOS METODOS Y RESULTADOS: Los 2231 pacientes hab�an sobrevivido la fase aguda de MI (3 a 16 d�as) y tenido una radionuclide fracci�n ventricular de expulsi�n < or = 40%. Patients were randomly assigned to receive double-blind treatment with either placebo or captopril and were followed for an average of 42 months. The influence of captopril on recurrent MI, cardiac revascularization procedures, and hospitalization with unstable angina was examined. The likelihood of recurrent MI was greater in patients with an MI or functional disability before the index infarction and higher systolic pressure (all P < .001) but was not influenced by baseline left ventricular ejection fraction. Therapy with captopril reduced the risk of development of recurrent MI by 25% (95% confidence intervals, 5% to 40%; P = .015) and the risk of death after recurrent MI by 32% (95% confidence intervals, 4% to 51%; P = .029). Captopril-assigned patients were also less likely to require cardiac revascularization procedures (P = .010), but hospitalization for unstable angina was unaltered. When all three of these major coronary ischemic events were considered together, captopril therapy reduced the risk (14% risk reduction; 95% confidence intervals, 0% to 26%; P = .047). CONCLUSIONS: In post-MI patients with asymptomatic left ventricular dysfunction, long-term administration of captopril reduced recurrence of MI and the need for cardiac revascularization but had no influence on the rate of hospitalization with a discharge diagnosis of unstable angina. The finding that the recurrence of MI was independent of left ventricular ejection fraction suggests that captopril could be useful in preventing recurrent MI in patients with more preserved left ventricular function. The need for cardiac revascularization was reduced in patients receiving long-term captopril therapy, suggesting either an anti- ischemic effect or the ability of the angiotensin-converting enzyme inhibitor to modify the atherosclerotic process in survivors of MI.
LA MALLA PRINCIPAL DIRIGE:
Captopril/*therapeut usa
Myocardial Infarction/*complica
Myocardial Infarction/*drug de terapia
Myocardial Ischemia/*prevention controla
LA MALLA ADICIONAL DIRIGE:
La angina, Unstable/epidemiolog
Doble - Ciego M�todo
El Coraz�n Hypertrophy/etiology
La Hospitalizaci�n
El Humano
La Incidencia
La Edad Media
Multivariate de An�lisis
Myocardial Infarction/mortality
Placebos
La Reaparici�n
Arriesgue Factores
Apoye, No - EE.UU. Gov't
El An�lisis de Supervivencia
LA PUBLICACION ESCRIBE:
EL ENSAYO CLINICO
EL ARTICULO DE DIARIO
EL ENSAYO CONTROLADO ALEATORIZADO
CAS DE REGISTRO NUMERA:
0 (Placebos)
62571-86-2 (Captopril)
LOS IDIOMAS:
Eng
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