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EL TITULO:	Los efectos de captopril sobre ischemic sucesos después de myocardial infarction. Los resultados de la Supervivencia y ensayo Ventricular de Ampliación. AHORRE Investigadores.
LOS AUTORES:	Rutherford JD; Pfeffer MA; Moye LA; Davis BR; Flaker GC; Kowey PR; Lamas GA; Molinero HS; Empacador M; Rouleau JL; et al
LA AFILIACION DE AUTOR:	El departamento de Medicina, Brigham y Hospital de Mujeres, Harvard de facultad de medicina, Boston, Masa.
LA FUENTE:	La circulación 1994 Oct;90(4):1731-8
LA CITACION IDS:	PMID: 7923656 UI: 95008096
ABSTRAIGA:	LOS ANTECEDENTES: En la Supervivencia y la Ampliación ventricular (AHORRA) ensayo, recurrente myocardial infarction (MI) era el más importante predictor de un resultado pobre y conferida un sevenfold el aumento en el riesgo de muerte. El propósito de este estudio estuvo para determinar el predictors de MI recurrente en participantes de estudio y para examinar la influencia del angiotensin-converti el inhibidor de enzima captopril sobre este y otro myocardial ischemic sucesos. LOS METODOS Y RESULTADOS: Los 2231 pacientes habían sobrevivido la fase aguda de MI (3 a 16 días) y tenido una radionuclide fracción ventricular de expulsión < or = 40%. Patients were randomly assigned to receive double-blind treatment with either placebo or captopril and were followed for an average of 42 months. The influence of captopril on recurrent MI, cardiac revascularization procedures, and hospitalization with unstable angina was examined. The likelihood of recurrent MI was greater in patients with an MI or functional disability before the index infarction and higher systolic pressure (all P < .001) but was not influenced by baseline left ventricular ejection fraction. Therapy with captopril reduced the risk of development of recurrent MI by 25% (95% confidence intervals, 5% to 40%; P = .015) and the risk of death after recurrent MI by 32% (95% confidence intervals, 4% to 51%; P = .029). Captopril-assigned patients were also less likely to require cardiac revascularization procedures (P = .010), but hospitalization for unstable angina was unaltered. When all three of these major coronary ischemic events were considered together, captopril therapy reduced the risk (14% risk reduction; 95% confidence intervals, 0% to 26%; P = .047). CONCLUSIONS: In post-MI patients with asymptomatic left ventricular dysfunction, long-term administration of captopril reduced recurrence of MI and the need for cardiac revascularization but had no influence on the rate of hospitalization with a discharge diagnosis of unstable angina. The finding that the recurrence of MI was independent of left ventricular ejection fraction suggests that captopril could be useful in preventing recurrent MI in patients with more preserved left ventricular function. The need for cardiac revascularization was reduced in patients receiving long-term captopril therapy, suggesting either an anti- ischemic effect or the ability of the angiotensin-converting enzyme inhibitor to modify the atherosclerotic process in survivors of MI.
LA MALLA PRINCIPAL DIRIGE:	Captopril/*therapeut usa Myocardial Infarction/*complica Myocardial Infarction/*drug de terapia Myocardial Ischemia/*prevention controla
LA MALLA ADICIONAL DIRIGE:	La angina, Unstable/epidemiolog Doble - Ciego Método El Corazón Hypertrophy/etiology La Hospitalización El Humano La Incidencia La Edad Media Multivariate de Análisis Myocardial Infarction/mortality Placebos La Reaparición Arriesgue Factores Apoye, No - EE.UU. Gov't El Análisis de Supervivencia
LA PUBLICACION ESCRIBE:	EL ENSAYO CLINICO EL ARTICULO DE DIARIO EL ENSAYO CONTROLADO ALEATORIZADO
CAS DE REGISTRO NUMERA:	0 (Placebos) 62571-86-2 (Captopril)
LOS IDIOMAS:	Eng

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