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Effects of canrenoate plus angiotensin-converting enzyme inhibitors versus angiotensin-converting enzyme inhibitors alone on systolic and diastolic function in patients with acute anterior myocardial infarction

Aldosterone (ALDO) exerts profibrotic effects, acting via the mineralocorticoid receptors in cardiovascular tissues. Aldosterone antagonism in combination with angiotensin-converting enzyme inhibition may better protect against the untoward effects of ALDO than angiotensin-converting enzyme inhibiti...

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Bibliographic Details
Published in:The American heart journal 2005-11, Vol.150 (5), p.919.e1-919.e8
Main Authors: Di Pasquale, Pietro, Cannizzaro, Sergio, Scalzo, Sebastiano, Parrinello, Gaspare, Fasullo, Sergio, Giambanco, Francesco, Fatta, Antonio, Paterna, Salvatore
Format: Article
Language:English
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Summary:Aldosterone (ALDO) exerts profibrotic effects, acting via the mineralocorticoid receptors in cardiovascular tissues. Aldosterone antagonism in combination with angiotensin-converting enzyme inhibition may better protect against the untoward effects of ALDO than angiotensin-converting enzyme inhibition alone. In a double-blind randomized study, the tolerability and efficacy of canrenoate (25 mg/d) plus captopril versus captopril alone were evaluated in 510 patients with an acute anterior myocardial infarction (MI), a serum creatinine concentration 2.0 mg/L after 10 days of treatment were observed. At 180 days, the mitral E-wave–A-wave ratio was higher ( P = .0001) and left ventricular end-systolic volume was smaller ( P = .0001) in patients treated with canrenoate than in those receiving placebo. No further side effects were observed during the study period. Our data suggest that the combination of captopril plus canrenoate is well tolerated after an acute MI and has beneficial effect on systolic and diastolic parameters and may decrease post-MI remodeling.
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2005.03.032