July 1, 1994European Heart Journal
Acute intervention with captopril during thrombolysis in patients with first anterior myocardial infarction
Why the study?
Does captopril reduce left ventricular volumes, ventricular arrhythmias, neurohumoral activation and enzymatic infarct size in patients with a first anterior myocardial infarction undergoing thrombolysis?
Population
298 patients with a first anterior myocardial infarction, eligible for thrombolytic therapy, within 6 h of…
Comparison
Captopril 6.25 mg started immediately upon… vs Matching placebo started immediately upon…
Design
RCT, randomized, double-blind, placebo-controlled
Follow-up
3 months
Authors
Discussion
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Implication
Supports early captopril during anterior MI thrombolysis to lower heart failure; extends ACEI benefits to arrhythmia and infarct size reduction in RCT.
Structured PICO
Does captopril reduce left ventricular volumes, ventricular arrhythmias, neurohumoral activation and enzymatic infarct size in patients with a first anterior myocardial infarction undergoing thrombolysis?
P
Population
298 patients with a first anterior myocardial infarction, eligible for thrombolytic therapy, within 6 h of onset of symptoms
I
Intervention
Captopril 6.25 mg started immediately upon streptokinase infusion and titrated to 2.5 mg t.i.d.
C
Comparator
Matching placebo started immediately upon streptokinase infusion
O
Outcome
Left ventricular volumes, ventricular arrhythmias, neurohumoral activation and enzymatic infarct sizesurrogate
Acute intervention with captopril during thrombolysis for first anterior myocardial infarction reduces ventricular arrhythmias, enzymatic infarct size, and subsequent heart failure incidence, despite a higher rate of initial hypotension.
Cite This Study
Kingma et al. (1994) studied this question.