Why the study?
Do pharmacological interventions such as thrombolytic therapy, aspirin, beta-blockers, and ACE inhibitors reduce mortality and morbidity in patients with acute myocardial infarction?
Do pharmacological interventions such as thrombolytic therapy, aspirin, beta-blockers, and ACE inhibitors reduce mortality and morbidity in patients with acute myocardial infarction?
Evidence from randomized clinical trials supports the routine use of thrombolytic therapy, aspirin, beta-blockers, and ACE inhibitors to reduce mortality in acute myocardial infarction.
Affirms foundational AMI therapies; leaves open optimization with contemporary strategies in updated trials.
This review summarizes the results of several pharmacological interventions that have been evaluated in the management of acute myocardial infarction. Of these, thrombolytic therapy, aspirin, beta-blockers and angiotensin converting enzyme inhibitors have all been proven to reduce mortality risk and the latter three classes of drugs have also been shown to reduce morbidity. Routine use of heparin or nitrates is not recommended although they may be useful in specific circumstances such as post-infarction angina or large infarcts. Drugs that have as yet not been shown to have a role in the routine management of acute myocardial infarction include Class I antiarrhythmic agents, magnesium and calcium antagonists. Management of patients with acute myocardial infarction can now be appropriately based on the evidence generated from well conducted randomized clinical trials and appropriate therapeutic choices based on such information can be expected to reduce their morbidity and mortality risks.
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Yusuf et al. (1996) studied this question.
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