Abstract:
:The pharmacologic management of the patient post myocardial infarction (MI) aims to achieve several goals. Chief among these is to prevent subsequent events, which include death, reinfarction, and rehospitalization. Secondary goals include preventing arrhythmias, minimizing left ventricular (LV) remodeling, and preventing progression to heart failure. This review describes practical algorithms for use in the pharmacologic management of the patient post MI based on American Heart Association/American College of Cardiology guidelines. The intensity of drug treatment is determined guided by the degree of LV dysfunction and the presence or absence of ischemia and arrhythmic risk markers. All patients post MI require an angiotensin-converting enzyme (ACE) inhibitor and antiplatelet therapy, usually with aspirin. In individuals who cannot tolerate an ACE inhibitor, an angiotensin receptor blocker (ARB) is an adequate substitute. Numerous studies document the efficacy of ACE inhibitors, which decrease mortality and the risk of heart failure and stroke. Aldosterone blockade is recommended long-term for patients post MI with an LV ejection fraction < or = 40% and either symptomatic heart failure or diabetes. Use of a beta blocker is an important addition to most post-MI drug regimens. Beta blockers decrease mortality and are especially effective in patients with impaired LV function. Among the beta blockers, carvedilol, which also has alpha-adrenergic receptor blocking activity, was found to decrease mortality significantly in patients with low ejection fractions and heart failure. Another drug therapy of value in post-MI treatment is use of calcium-channel blockers. These are restricted to patients with conserved LV function in whom congestion is absent and in whom beta blockers are contraindicated. Current guidelines also recommend that patients post MI with elevated cholesterol levels should be prescribed lipid therapy with a statin at hospital discharge.
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Reiffel JA,American Heart Association.,American College of Cardiology.doi
10.1002/clc.4960281306subject
Has Abstractpub_date
2005-11-01 00:00:00pages
I28-37issue
11 Suppl 1eissn
0160-9289issn
1932-8737journal_volume
28pub_type
杂志文章,评审abstract:BACKGROUND:The prognostic ability of cardiac troponin I (TnI) has been demonstrated in general populations and among cardiovascular disease patients, but it has not been evaluated in cancer patients. HYPOTHESIS:This study assumes to have the prognostic ability of cardiac troponin in cancer patients visiting the emerge...
journal_title:Clinical cardiology
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doi:10.1002/clc.23486
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Data are being accumulated on the presence of inflammatory response in patients with acute coronary syndromes. HYPOTHESIS:The study was undertaken to confirm that the adhesive state of the peripheral blood leukocytes can provide information on an inflammatory process in patients with unstable angina pectori...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960201208
更新日期:1997-12-01 00:00:00
abstract::201Thallium (201Tl) perfusion scintigraphy was performed in 22 patients with first acute transmural myocardial infarction within the initial 12 h after onset of symptoms. The size of the abnormally perfused area on 201Tl images was estimated by visual analysis and by a computer-assisted technique. 201Tl values for inf...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:
更新日期:1980-04-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960200207
更新日期:1997-02-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:2000-09-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:2015-10-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22231
更新日期:2014-03-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960201021
更新日期:1997-10-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.20518
更新日期:2009-09-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960151111
更新日期:1992-11-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960130311
更新日期:1990-03-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960050402
更新日期:1982-04-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究
doi:10.1002/clc.22362
更新日期:2015-02-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.22224
更新日期:2014-02-01 00:00:00
abstract:BACKGROUND:Low levels of high-density lipoprotein cholesterol (HDL-C; <40 mg/dL) are associated with increased risk of cardiovascular events, but it is unclear whether lower thresholds (<30 mg/dL) are associated with increased hazard. HYPOTHESIS:Very low levels of HDL-C may provide prognostic information in acute coro...
journal_title:Clinical cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1002/clc.22533
更新日期:2016-06-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
doi:10.1002/clc.20136
更新日期:2008-03-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960110614
更新日期:1988-06-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960270605
更新日期:2004-06-01 00:00:00
abstract:BACKGROUND:Emerging biomarkers for acute myocardial infarction (AMI) may enhance conventional risk-prediction algorithms if they are informative and associated with risk independently of established predictors. In this study, we constructed a cohort for testing emerging biomarkers for AMI in managed-care populations us...
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pub_type: 杂志文章,多中心研究
doi:10.1002/clc.22146
更新日期:2013-08-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,随机对照试验
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更新日期:2016-11-01 00:00:00
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更新日期:2017-10-01 00:00:00
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更新日期:1986-09-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
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更新日期:2000-04-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:2018-06-01 00:00:00
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journal_title:Clinical cardiology
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更新日期:2014-11-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:2010-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960200514
更新日期:1997-05-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:1982-07-01 00:00:00
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更新日期:2012-03-01 00:00:00
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更新日期:2018-11-01 00:00:00