Effects of early losartan therapy on ventricular late potentials in acute myocardial infarction.
BACKGROUND
Ventricular late potentials (LPs) obtained by the signal-averaged electrocardiogram (SAECG) have prognostic significance as independent predictors of arrhythmic events after an acute myocardial infarction (AMI). Angiotensin receptor blockers reduce the overall mortality and risk of sudden cardiac death in postinfarction patients. The aim of this study was to investigate the effect of early losartan therapy on ventricular LPs, a noninvasive method for the evaluation of arrhythmogenic substrates in AMI patients.


METHODS
The study included 97 patients with their first AMI. Forty-eight patients (39 men and 9 women, aged 58.8 +/- 13.19 years), received early losartan therapy. The control group consisted of 49 patients (38 men and 11 women, aged 59.55 +/- 11.0 years), did not received early losartan therapy. The SAECG was performed at admission and day 14.


RESULTS
The baseline clinical, angiographic characteristics, and reperfusion methods were similar in both groups. The baseline SAECG findings were also similar in the two groups. There was a significant decrease in the rate of LP, between the first and last SAECG recordings, after reperfusion therapy in the losartan group. All of the parameters of LPs were significantly improved in the losartan group on the last SAECG recordings.


CONCLUSIONS
The results of this study showed that losartan treatment, early after an AMI, reduced the incidence of LP and may thus favorably affect arrhythmia substrates.
Kim
Dae-Hyeok
DH
Department of Cardiology, Inha University College of Medicine, Incheon, Korea. kdhmd@inha.ac.kr
Choi
Woong-Gil
WG
Kwan
Jun
J
Park
Keum-Soo
KS
Lee
Woo-Hyung
WH
D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D019808:Losartan / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000503:physiopathology; D011379:Prognosis; D012815:Signal Processing, Computer-Assisted; D016276:Ventricular Function
D047228:Angiotensin II Type 1 Receptor Blockers; D000889:Anti-Arrhythmia Agents; D019808:Losartan