Combination therapy with lisinopril and losartan was more effective than individual treatments in reducing mortality and ventricular remodeling in rats 3 months after myocardial infarction.
Does combination therapy with lisinopril and losartan improve ventricular remodeling and survival in rats after myocardial infarction compared to either drug alone or no treatment?
In a rat model of myocardial infarction, combining an ACE inhibitor and an AT1 receptor antagonist was more effective than either agent alone in preventing ventricular remodeling and improving survival.
BACKGROUND: There are limited data regarding the effects of angiotensin II receptor blockade after myocardial infarction (MI). In addition, whether combined angiotensin converting enzyme (ACE) inhibitor and angiotensin II type I (AT(1)) receptor antagonist may be superior to either drug alone on ventricular remodeling remains unclear. The goal of this study was to determine if the cardiac effects of the combined administration of an ACE inhibitor and AT(1) receptor antagonist are greater than those produced by either of these agents administered individually after MI. METHODS AND RESULTS: After MI, rats were divided into 4 groups: 1) untreated animals, 2) lisinopril treatment (20 mg/kg/day), 3) losartan treatment (20 mg/kg/day), and 4) lisinopril plus losartan treatment. After 3 months, the cardiac parameters studied were: mortality, fibrosis (hydroxyproline), hypertrophy (ventricular weight/body weight ratio VW/BW), left ventricular enlargement (volume at end-diastolic pressure equaled zero/body weight ratio V0/BW), and ventricular function (isovolumetric developed pressure, dp/dt, -dp/dt). A lowest mortality rate in the animals treated with the combination of both ACE inhibitor and AT(1) receptor antagonist was observed. Although lisinopril and losartan significantly decreased VW/BW ratio, when administered concomitantly, VW/BW ratio was lower than when either agent was administered individually. There were no differences in right ventricle hydroxyproline concentration. Only combination therapy decreased V0/BW ratio. The treatment with lisinopril plus losartan resulted in increases in the development of pressure versus untreated group; without alteration in dp/dt and -dp/dt. CONCLUSIONS: The combination of the AT(1) receptor blockade and ACE inhibitor is more effective than individual treatment on ventricular remodeling and survival after MI in rats.
Zornoff et al. (Fri,) conducted a other in Myocardial Infarction. Lisinopril plus losartan vs. Untreated, lisinopril alone, and losartan alone was evaluated on Mortality, ventricular remodeling, and ventricular function. Combination therapy with lisinopril and losartan was more effective than individual treatments in reducing mortality and ventricular remodeling in rats 3 months after myocardial infarction.
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