Testa M, Sonnenblick E H, Lejemtel T H
Department of Medicine, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
J Cardiovasc Risk. 1995 Oct;2(5):429-33. doi: 10.1177/174182679500200507.
Numerous large, double-blind, randomized trials have demonstrated that, overall, angiotensin converting enzyme (ACE) inhibition improves survival of patients after acute myocardial infarction (AMI). However, several practical issues concerning ACE inhibition in the presence of AMI have not yet been answered. These include whether ACE inhibition should be initiated in all patients with AMI, how soon ACE inhibition should be attempted in relation to onset of pain and possibly thrombolysis, and, lastly, how long ACE inhibition should be maintained after the acute event. Each of these issues is addressed, and recommendations are made on the basis of the results from recent randomized trials in AMI and congestive heart failure.
大量大型双盲随机试验表明，总体而言，急性心肌梗死（AMI）后使用血管紧张素转换酶（ACE）抑制剂可提高患者生存率。然而，关于AMI患者使用ACE抑制剂的几个实际问题尚未得到解答。这些问题包括是否应在所有AMI患者中开始使用ACE抑制剂，与疼痛发作及可能的溶栓治疗相关，应多快尝试使用ACE抑制剂，以及最后，急性事件后ACE抑制剂应维持使用多长时间。本文针对每个问题进行了探讨，并根据近期AMI和充血性心力衰竭随机试验的结果给出了建议。
