Imidapril and enalapril similarly inhibit plasma matrix metalloproteinase activities and attenuate left ventricular remodeling in patients with acute myocardial infarction.
Matrix metalloproteinase (MMP) plays a critical role in the development of ventricular remodeling after acute myocardial infarction (AMI). Imidapril, an angiotensin-converting enzyme inhibitor, has been shown to inhibit MMP activity. We investigated whether imidapril inhibits plasma MMP activities and attenuates ventricular remodeling in patients with AMI in comparison with enalapril. We enrolled 70 patients with AMI. All patients underwent primary percutaneous coronary intervention and were randomly assigned either to imidapril (n = 35) or to enalapril (n = 35) treatment. Left ventriculography was performed in acute (day 14) and chronic (6 months) phases, and plasma MMP-2 and MMP-9 activities were measured by zymography. Any changes in left ventricular end-diastolic volume index and ejection fraction from acute to chronic phases did not differ between the 2 groups. The plasma MMP-2 and MMP-9 activities at day 14 were both significantly decreased compared with those at day 1 in both groups (all P < 0.05). At 6 months, MMP-9 activity still remained decreased in both groups (P < 0.05 vs. day 1). Overall, there were no differences between the 2 groups both in plasma MMP-2 and MMP-9 activities. These results demonstrate that imidapril exerts inhibitory effects on plasma MMP activities and attenuates left ventricular remodeling in patients with AMI similar to enalapril.
*Department of Cardiology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan; †Department of Cardiology and Respiratory Medicine, Aomori City Hospital, Aomori, Japan; ‡Second Department of Internal Medicine, Goshogawara City Seihoku Central Hospital, Goshogawara, Japan; §Department of Cardiology, Hachinohe City Hospital, Hachinohe, Japan; and ¶Department of Cardiology and Respiratory Medicine, Aomori Rosai Hospital, Hachinohe, Japan.
Takashi
T
Yokota
Hirofumi
H
Tomita
Yasuhiro
Y
Mori
Takeshi
T
Kudo
Hitoshi
H
Hiraga
Naoyuki
N
Suto
Takumi
T
Higuma
Naoki
N
Abe
Hiroyuki
H
Hanada
Tomohiro
T
Osanai
Ken
K
Okumura
D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D004656:Enalapril / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D048289:Imidazolidines / Q000494:pharmacology / Q000627:therapeutic use*; D008297:Male; D061965:Matrix Metalloproteinase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D020782:Matrix Metalloproteinases / Q000097:blood*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000188:drug therapy; D020257:Ventricular Remodeling / Q000187:drug effects* / Q000502:physiology
D000806:Angiotensin-Converting Enzyme Inhibitors; D048289:Imidazolidines; D061965:Matrix Metalloproteinase Inhibitors; D004656:Enalapril; C065166:imidapril; D020782:Matrix Metalloproteinases