[Prevention of postinfarction cardiac insufficiency: role of angiotensin converting enzyme inhibitors].
Cardiac failure remains a serious complication of myocardial infarction. In addition to therapeutic interventions to limit the infarct size, it would seem possible to influence the progressive changes in geometry and size of the left ventricle, known as remodeling. Experimental and clinical studies have shown beneficial effects of angiotensin converting enzyme inhibitors and the SAVE trial evaluated the prognostic consequences of this therapy, reporting a significant reduction in mortality after 10 months' treatment. Many questions remain which require further research in this field, mainly concerning the optimal time of introduction the treatment, the importance of the chemical molecule used, the most appropriate dosage and the influence of associated drug therapy. ACE inhibitors are now part of the therapeutic arsenal of myocardial infarction but their prescription should be strictly reserved for the population concerned by these trials, that is to say patients with a recent, extensive infarct with left ventricular dysfunction but without clinical signs of cardiac failure.
Guéret
P
P
Service de cardiologie, CHU 2, Limoges.
Cohen-Solal
A
A
Bensaid
J
J
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D005500:Follow-Up Studies; D006333:Heart Failure / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D009203:Myocardial Infarction / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D011379:Prognosis; D016277:Ventricular Function, Left
D000806:Angiotensin-Converting Enzyme Inhibitors
Prévention de l'insuffisance cardiaque postinfarctus: la place des inhibiteurs de l'enzyme de conversion.