Long-Term Pharmacological Management of Reduced Ejection Fraction Following Acute Myocardial Infarction: Current Status and Future Prospects

Heart failure (HF) with reduced ejection fraction is common following acute myocardial infarction (MI), and active medical management can have a profound impact on prognosis. Reviewing relevant clinical trials, we focus on the pharmacological management of left ventricular systolic dysfunction (LVSD...

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Bibliographic Details
Published in:International journal of general medicine 2021-01, Vol.14, p.7797-7805
Main Authors: Abel, Alexandra AI, Clark, Andrew L
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Angiotensin
Angiotensin converting enzyme
Anticoagulants
Apixaban
Aspirin
Beta blockers
Cardiac patients
Cardiovascular disease
Coronary vessels
Ejection fraction
Enzymes
Health aspects
Heart attack
Heart attacks
heart failure
Heart rate
hefref
Ivabradine
Magnetic resonance imaging
Meta-analysis
Mortality
myocardial infarction
Prognosis
Review
Rivaroxaban
Sinuses
Stroke
Trandolapril
United Kingdom
Valsartan
Vein & artery diseases
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Summary:Heart failure (HF) with reduced ejection fraction is common following acute myocardial infarction (MI), and active medical management can have a profound impact on prognosis. Reviewing relevant clinical trials, we focus on the pharmacological management of left ventricular systolic dysfunction (LVSD) following an acute MI, although there is overlap with the pharmacological management of chronic HF due to reduced ejection fraction. Angiotensin converting enzyme (ACE) inhibitors, beta-blockers, and mineralocorticoid receptor antagonists are the mainstay of medical management in patients with LVSD post MI; there may also be a role for anticoagulation. Sacubitril-valsartan (angiotensin receptor neprilysin inhibitor) has not yet been shown to be superior to an ACE inhibitor in reducing cardiovascular mortality and HF events in patients with LVSD post MI. Large randomised trials evaluating sodium glucose transporter 2 (SGLT-2) inhibitors in LVSD post MI are ongoing. Keywords: heart failure, HeFREF, myocardial infarction
ISSN:1178-7074
1178-7074
DOI:10.2147/IJGM.S294896