| Popis: |
Objectives. The use of an angiotensin-converting enzyme inhibitor (ACE-I) or an angiotensinreceptor antagonists (ARBs) reduces the incidence of heart failure and the risk of thrombosis after acute ST-elevation myocardial infarction (STEMI) blockade of the renin-angiotensinaldosterone system (RAAS).There are some differences between ACE-I and ARBs, as more than 75% of angiotensin II in human myocardium originates from the alternative pathway influenced only by ARB. Goal. To compare the effect of 8-week and 6-month treatment of AMI patients with ramipril and losartan on laboratory markers, echocardiographic parameters and clinical signs of heart failure. Patients and methods.108 patients who suffered an STEMI were randomized in a ramipril (55) and a losartan (53) group, and followed-up for 8 weeks and 6 months. During treatment the effect of drugs on clinical (Killip-Kimbal classes), laboratory markers (NT-pro BNP, PAI-1, lipidogram) and echocardiographical parameters (EFLV, LVEDD) were compared. Results. No statistically significant differences in the levels of laboratory markers, echocardiographic parameters and clinical signs of heart failure were observed between the ramipril and the losartan group, neither after 8-week nor after 6-month treatment. Conclusions. After an uncomplicated STEMI, losartan was equally effective as ramipril in terms of laboratory markers, echocardiographic parameters and clinical signs of heart failure. |
