[Hyperaldosteronism in the acute phase of myocardial infarction. Effects of its treatment on the prevention of ventricular fibrillation].

Many metabolic and hormonal changes are observed during the acute phase of myocardial infarction (glucose metabolism, lipoproteins...). Mineralocorticoid function may also be disturbed but there have been few studies of this problem. The aim of this study was to confirm the elevation of serum aldosterone during the acute phase of myocardial infarction and to determine the effects of antialdosterone treatment in these patients. Hyperaldosteronism was confirmed in 74% of 72 consecutive patients admitted for acute myocardial infarction, in 85% if patients previously treated by an antialdosterone drug or admitted after the acute phase are excluded, and in 96% if patients with cardiac failure are included. One thousand consecutive patients admitted for myocardial infarction were given an antialdosterone agent systematically (intravenous potassium canrenoate , 600 mg daily for 5 days). The serum and red blood cell potassium concentrations rose, the number of ventricular extrasystoles and the administration of anti-arrhythmic drugs fell, and, above all, the prevalence of ventricular fibrillation decreased significantly: 0,8% (p less than 0,001), compared with comparable previously reported series.