ACE-inhibitors plus mineralocorticoid antagonists versus ACE-inhibitors in patients with anterior myocardial infarction: Short term effects

Introduction: There is recent evidence that aldosterone exerts profibrotic effects. Methods: We compared effects of canreonate (can.)+captopril (cap.) vs cap alone in pts with anterior AMI, 187 pts were randomised in 2 groups: group A (94 pts) received cap and 25 mg i.v.of can (1 mg/h for the 1(st) 72 h and then orally 25 mg/day. Group B (93 ptis) received cap and placebo. At entry,10 and 90 days after admission echocardiography was performed to determine ESV, EF, EDV, E/A ratio, dec. time and IVRT Results: The 2 groups were similar. E/A ratio was higher in can group than placebo, p=0.001), and ESV was higher in placebo than can group after 90 days. (p=0.021), No side effects were observed. Conclusions: The combination of cap+can in feasible in early AMI pts,and has more effect on E/A ratio and ESV than cap alone.