Causes of death in patients with acute myocardial infarction treated with angiotensin-converting enzyme inhibitors: Findings from the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto (GISSI)–3 trial

Pedrazzini, Giovanni; Santoro, Eugenio; Latini, Roberto; Fromm, Laurie; Franzosi, Maria Grazia; Mocetti, Tiziano; Staszewsky, Lidia; Barlera, Simona; Tognoni, Gianni; Maggioni, Aldo P.

doi:10.1016/j.ahj.2007.10.015

Cited by 25 publications

(11 citation statements)

References 29 publications

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“…An early and effective intervention strategy for CR prevention is necessary. Early use of β-blockers and ACEI/ARB could help to prevent CR for patients with high CR risk (Figueras et al, 2008; Pedrazzini et al, 2008). Primary PCI therapy rather than thrombolysis could reduce the incidence of CR (Yip et al, 2003;Okino et al, 2005;Figueras et al, 2008;Qian et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Predictive factors of cardiac rupture in patients with ST-elevation myocardial infarction

Qian

Chen

et al. 2014

J. Zhejiang Univ. Sci. B

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Cardiac rupture (CR) is a potentially fatal mechanical complication of ST-elevation myocardial infarction (STEMI). We aimed to determine the incidence and risk factors of CR in Chinese STEMI patients. A total of 9798 consecutive STEMI patients from four centers in China were retrospectively analyzed, among which 178 patients had CR. STEMI patients without CR were chosen as a control group. Clinical characteristics were compared between STEMI patients with CR and those without CR. The incidence of CR in STEMI patients was 1.82%, and the 30-d mortality was up to 61.2%. CR patients were significantly older, more female, and associated with a longer time from onset of pain to hospital admission than their non-CR counterparts (P<0.001). More patients with anterior myocardial infarction (82.1%) were found in the CR group, and CR patients had significantly higher heart rates than the control group ((91±19) bpm vs. (71±16) bpm; P<0.001). In multiple-adjusted models, the independent risk factors of CR were advanced age, female gender, anaemia, increased heart rate, anterior myocardial infarction, increased white blood cell (WBC) count, delayed admission, and renal dysfunction. The level of hemoglobin remained a significant determinant factor of CR (OR (95% CI): 0.82 (0.75-0.89); P<0.001) after adjusting for various potential confounding factors. Counts of WBC also remained a significant determinant of the CR (OR (95% CI): 1.08 (1.04-1.12); P<0.001). A number of variables were independently related to CR. This study indicated, for the first time, that both hemoglobin and WBC levels were independently correlated with occurrence of CR.

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Section: Discussionmentioning

confidence: 99%

Predictive factors of cardiac rupture in patients with ST-elevation myocardial infarction

Qian

Chen

et al. 2014

J. Zhejiang Univ. Sci. B

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“…CR is a complication of myocardial infarction with an exceedingly high mortality rate (French et al, 2010). The incidence of mechanical complication after AMI is 0.4% to 0.9% (Okino et al, 2005;Pedrazzini et al, 2008;French et al, 2010;López-Sendón et al, 2010). In our study, the mechanical complication rate was 0.70%.…”

Section: \ 4 Discussionmentioning

confidence: 43%

“…To minimize OR: odds ratio; CI: confidence interval the incidence of CR, we should avoid the triggers of mechanical complication for patients with high CR risk, such as prolonging the bed time, avoidance of strenuous activities, acesodyne, sedation, laxative, prevention of severe coughing, and vomiting. Early use of β-blockers and ACEIs or ARB could also help to prevent CR (Figueras et al, 2008;Pedrazzini et al, 2008). Current therapy of CR consists mainly of surgery with high mortality (Sakaguchi et al, 2008;Haddadin et al, 2009).…”

Section: \ 4 Discussionmentioning

confidence: 99%

Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage

Qian

Liu

Wang

et al. 2013

J. Zhejiang Univ. Sci. B

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Although cardiac rupture (CR) is a fatal mechanical complication of acute myocardial infarction (AMI), to date no predictive model for CR has been described. CR has common pathological characteristics with major bleeding. We aimed to investigate the relationship between the risk factors of major bleeding and CR. A total of 10202 consecutive AMI patients were recruited, and mechanical complications occurred in 72 patients. AMI patients without CR were chosen as control group. Clinical characteristics including bleeding-related factors were compared between the groups. The incidences of free wall rupture (FWR), ventricular septal rupture (VSR), and papillary muscle rupture (PMR) were 0.39%, 0.21%, and 0.09%, respectively, and the hospital mortalities were 92.5%, 45.5%, and 10.0%, respectively. Female proportion and average age were significantly higher in the groups of FWR and VSR than in the control group (P<0.01); higher white blood cell count and lower hemoglobin were found in all CR groups (P<0.01). Compared to the control group, patients with CR were more likely to receive an administration of thrombolysis [26.39% vs. 13.19%, P<0.05], and were less likely to be treated with primary percutaneous coronary intervention (PCI) [41.67% vs. 81.60%, P<0.05]. The major bleeding scores (integer scores) of FWR, VSR, and PMR were (17.70±7.24), (21.91±8.33), and (18.60±7.88), respectively, and were significantly higher than that of the control group (11.72±7.71) (P<0.05). A regression analysis identified age, increased heart rate, anemia, higher white blood cell count, and thrombolysis as independent risk factors of CR, most of which were major bleeding-related factors. The patients with CR have a significantly higher risk of hemorrhage compared to the group without CR. Risk of CR after AMI is related to the risk of hemorrhage.

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“…The beneficial effects of lisinopril observed at 6 weeks (8 fewer deaths per 1000 treated patients) were maintained up to nearly 5 years (10 fewer deaths per 1000). 16 Thus, the use of ACE inhibitors during the early phases of AMI has proven long-term advantages in terms of clinical outcomes.…”

Section: Discussionmentioning

confidence: 99%

Early Treatment With Zofenopril and Ramipril in Combination With Acetyl Salicylic Acid in Patients With Left Ventricular Systolic Dysfunction After Acute Myocardial Infarction: Results of a 5-Year Follow-up of Patients of the SMILE-4 Study

Borghi

Omboni

Novo

et al. 2017

Journal of Cardiovascular Pharmacology

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Abstract:The SMILE-4 study showed that in patients with left ventricular dysfunction (LVD) after acute myocardial infarction, early treatment with zofenopril plus acetyl salicylic acid is associated with an improved 1-year survival, free from death or hospitalization for cardiovascular (CV) causes, as compared to ramipril plus acetyl salicylic acid. We now report CV outcomes during a 5-year follow-up of the patients of the SMILE-4 study. Three hundred eighty-six of the 518 patients completing the study (51.2%) could be tracked after the study end and 265 could be included in the analysis. During the 5.5 (±2.1) years of follow-up, the primary endpoint occurred in 27.8% of patients originally randomized and treated with zofenopril and in 43.8% of patients treated with ramipril [odds ratio (OR) and 95% confidence interval, 0.65 (0.43–0.98), P = 0.041]. Such a result was achieved through a significantly larger reduction in CV hospitalization under zofenopril [OR: 0.61 (0.37–0.99), P = 0.047], whereas reduction in mortality rate with zofenopril did not achieve statistical significance versus ramipril [OR: 0.75 (0.36–1.59), P = 0.459]. These results were in line with those achieved during the initial 1-year follow-up. Benefits of early treatment of patients with LVD after acute myocardial infarction with zofenopril are sustained over many years as compared to ramipril.

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Causes of death in patients with acute myocardial infarction treated with angiotensin-converting enzyme inhibitors: Findings from the Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto (GISSI)–3 trial

Cited by 25 publications

References 29 publications

Predictive factors of cardiac rupture in patients with ST-elevation myocardial infarction

Predictive factors of cardiac rupture in patients with ST-elevation myocardial infarction

Risk of cardiac rupture after acute myocardial infarction is related to a risk of hemorrhage

Early Treatment With Zofenopril and Ramipril in Combination With Acetyl Salicylic Acid in Patients With Left Ventricular Systolic Dysfunction After Acute Myocardial Infarction: Results of a 5-Year Follow-up of Patients of the SMILE-4 Study

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