Inhibiting the renin-angiotensin system with ACE Inhibitors or ARBs after MI.
As part of the recommended modern post-myocardial infarction (MI) management, including reperfusion strategies, antiplatelet therapy, and beta-blockers, we may wonder whether the impact of early inhibition of the renin-angiotensin system (RAS) is as important as it was 20 years ago. This review demonstrates that significant clinical benefit can be derived from angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) even when added to other currently recommended treatment strategies in post-MI patients. Moreover, the effects of RAS inhibition extend far beyond the early post-MI neurohormonal activation and left ventricular remodeling phases. The favorable effects of RAS inhibition on important prognostic markers such as atrial fibrillation, renal function, and diabetes have recently been unraveled. Post-MI RAS inhibition also benefits all age groups, including elderly patients.
Palardy
Maryse
M
Montreal Heart Institute (Université de Montréal), 5000 Belanger, Montreal, QC, H1T 1C8, Canada.
Ducharme
Anique
A
O'Meara
Eileen
E
D047228:Angiotensin II Type 1 Receptor Blockers / Q000494:pharmacology*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D006801:Humans; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology; D012084:Renin-Angiotensin System / Q000187:drug effects*; D016896:Treatment Outcome; D020257:Ventricular Remodeling / Q000187:drug effects*
D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors