Location of Repository

MYOCARDIAL ISCHAEMIA: NEW EVIDENCE FOR ANGIOTENSIN-CONVERTING ENZYME INHIBITION

By R. Ferrari, G. Guardagli, D. Mele, M. Valgimigli and C. Ceconi

Abstract

Angiotensin-converting enzyme (ACE) inhibitors undoubtedly represent a milestone\ud in cardiovascular therapy. They are known to halt the progression of coronary artery\ud disease by interrupting the series of events that lead to end-stage ischaemic heart\ud disease. Moreover, in patients with severe heart failure, ACE inhibitors, quite\ud surprisingly, reduce the recurrence of angina pectoris and myocardial infarction,\ud hospitalization for ischaemic heart disease, and the rate of coronary artery bypass\ud surgery or angioplasty. More recently ACE inhibitors have been postulated to reduce\ud vascular hypertrophy, attenuate atherosclerosis and influence mortality and\ud hospitalization when used in patients with left ventricular dysfunction without overt\ud heart failure. The results of the Heart Outcomes Prevention Evaluation (HOPE) study\ud confirm that this is the case, and that these agents can reduce the incidence of\ud coronary events. Two other major trials, on the same subject but substantially\ud different from HOPE, namely the EUropean trial on Reduction Of cardiac events with\ud Perindopril in stable coronary Artery disease (EUROPA) and the Prevention of Events\ud with ACE inhibitors (PEACE) study, are underway. The clinical hypothesis to be tested\ud is that prolonged ACE inhibition reduces the progression of coronary atherosclerosis;\ud the biological hypothesis is that prolonged ACE inhibition reduces or even reverses\ud endothelial dysfunction to normal—a mechanism in which bradykinin might be\ud significantly involved. This is the main topic of the present article

Year: 2003
DOI identifier: 10.1016/S1520-765X(03)90027-7
OAI identifier: oai:iris.unife.it:11392/1736189
Download PDF:
Sorry, we are unable to provide the full text but you may find it at the following location(s):
  • http://hdl.handle.net/11392/17... (external link)
  • Suggested articles


    To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.