title: Chronic pretreatment of ACEI reduces no-reflow in patients with acute myocardial infarction treated with primary angioplasty.
abstract: BACKGROUND
  In animal models, pretreatment with angiotensin-converting enzyme inhibitor (ACEI) can reduce no-reflow. In the present study, we investigated whether pretreatment with ACEI may prevent no-reflow in patients who underwent primary coronary intervention for AMI.
  
  
  RESULTS
  A total of 259 consecutive patients who underwent primary angioplasty for a first AMI were studied. No-reflow was defined as a TIMI flow grade < 3. The no-reflow phenomenon was found in 33 of 259 patients. There were no significant differences in clinical characteristics between the patients with and without ACEI pretreatment. However, the 47 patients receiving chronic ACEI treatment before admission had lower incidence of the no-reflow than those without it (4.2 and 14.6%, p<0.05). Multivariable logistic regression analysis revealed that absence of ACEI pretreatment was a significant predictor of the no-reflow along with absence of preinfarction angina, complete occlusion of the culprit lesion, high-burden thrombus, ejection fraction on admission, number of Q-waves, absence of statin pretreatment, and anterior AMI.
  
  
  CONCLUSIONS
  Pretreatment with ACEI could preserve the microvascular integrity after acute myocardial infarction in humans.
authors: Department of Cardiology, Cardiovascular Institute and Fu-Wai Heart Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
authors: Jing-Lin
authors: JL
authors: Zhao
authors: Yue-Jin
authors: YJ
authors: Yang
authors: Yuan-Hui
authors: YH
authors: Zhang
authors: Wei-Dong
authors: WD
authors: Pei
authors: Yu-Hua
authors: YH
authors: Sun
authors: Ji-Lin
authors: JL
authors: Chen
authors: Run-Lin
authors: RL
authors: Gao
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001783:Blood Flow Velocity / Q000187:drug effects; D002216:Captopril / Q000627:therapeutic use; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects*; D004562:Electrocardiography; D004656:Enalapril / Q000627:therapeutic use; D005260:Female; D017328:Fosinopril / Q000627:therapeutic use; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D011237:Predictive Value of Tests; D012107:Research Design; D013318:Stroke Volume / Q000187:drug effects; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D004656:Enalapril; D002216:Captopril; D017328:Fosinopril