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Effects of early captopril therapy after myocardial infarction on the incidence of late potentials.

Abstract：

BACKGROUND:Late potentials (LP) on signal-averaged electrocardiography (SAECG), recorded 6 to 30 days after an acute myocardial infarction (AMI), identify patients at risk for late arrhythmic events. Angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce ventricular remodeling and cardiovascular mortality after AMI. HYPOTHESIS:The aim of this study was to investigate the effect of early (< 24 h) administration of captopril on the presence of LP on Days 6-30 after AMI. METHODS:The study included 117 patients with a first AMI; 63 patients (53 men and 10 women, aged 59 +/- 12 years), 35 with an anterior and 28 with an inferior AMI (44 thrombolyzed), received early captopril therapy. The control group consisted of 54 age-matched patients (39 men and 15 women, aged 60 +/- 12 years), 19 with an anterior and 35 with an inferior AMI (31 thrombolyzed, p = NS), who did not receive early therapy with an ACE inhibitor. The mean left ventricular ejection fraction was similar in both groups (48 vs. 46%). Time domain analysis of SAECG was performed using a band-pass filter of 40-250 Hz. Late potentials were considered present if any two of three criteria were met: (1) Filtered QRS duration (QRSD) > 114 ms, (2) root-mean-square voltage of the last 40 ms of the QRS complex (RMS) < 20 microV, and (3) duration of low amplitude (< 40 microV) signal of the terminal portion of the QRS (LAS) > 38 ms. RESULTS:In the two groups of patients there were no differences in mean values of SAECG parameters. No patient was receiving any antiarrhythmic drugs. In the captopril group LPs were present in 9 of 63 patients (14%) and in the control group in 17 of 54 patients (31%) (p = 0.046). There was no difference in the number of patients with a patent infarct-related artery in the two groups (76 vs. 59%). CONCLUSION:Captopril treatment early after an AMI reduces the incidence of LPs recorded on Days 6-30 and may thus favorably affect the arrhythmogenic substrate.

journal_name

Clin Cardiol

journal_title

Clinical cardiology

authors

Chiladakis JA,Karapanos G,Agelopoulos G,Alexopoulos D,Manolis AS

doi

10.1002/clc.4960230206

subject

Has Abstract

pub_date

2000-02-01 00:00:00

pages

96-102

issue

eissn

0160-9289

issn

1932-8737

journal_volume

pub_type

临床试验,杂志文章

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Effects of early captopril therapy after myocardial infarction on the incidence of late potentials.