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Article: Comparison of perindopril versus captopril for treatment of acute myocardial infarction

TitleComparison of perindopril versus captopril for treatment of acute myocardial infarction
Authors
Issue Date2002
PublisherExcerpta Medica, Inc. The Journal's web site is located at http://www.ajconline.org/
Citation
American Journal Of Cardiology, 2002, v. 89 n. 2, p. 150-154 How to Cite?
AbstractAngiotensin-converting enzyme (ACE) inhibitors reduce mortality in patients with acute myocardial infarction (AMI), but these benefits might be limited by acute hemodynamic changes and difficulties in titrating to recommended doses. The objective of this study was to compare the hemodynamic changes and tolerability of perindopril with captopril after AMI. We randomized 212 patients to receive either captopril (n = 102) or perindopril (n = 110) within 72 hours of AMI. Captopril was given as an initial dose of 6.25 mg, and then 50 mg/day on day 1 and 100 mg/day thereafter. The corresponding doses of perindopril were 2, 4, and 8 mg/day. Acute hemodynamic changes, the percentage of patients who reached target doses, and in-hospital and 6-month cardiovascular events were monitored. Baseline clinical characteristics of the 2 groups were identical, but patients randomized to perindopril were in a higher Killip class (1.4 ± 0.6 vs 1.2 ± 0.5, p = 0.05). During the first 6 hours, treatment with perindopril resulted in higher minimal systolic (97 ± 15 vs 91 ± 14 mm Hg, p <0.01) and diastolic blood pressure (BP) (57 ± 11 vs 54 ± 10 mm Hg, p <0.02), later occurrence of minimal BP (3.6 ± 0.2 vs 2.7 ± 0.1 hour, p <0.001), and a lower incidence of persistent hypotension with systolic BP <90 mm Hg for ≥1 hour (5% vs 16%; p <0.01) compared with captopril. At initial administration, target doses of perindopril and captopril were attained in 97% and 82% of the patients, respectively (p <0.01). After 6 months, there were no differences between patients treated with perindopril and captopril in mortality rates (6% vs 13%, p = 0.16) and need for revascularization (20% vs 21%, p = 0.9). Thus, in patients during AMI, perindopril treatment showed better short-term tolerance than treatment with captopril, with significantly less acute hemodynamic changes and fewer withdrawals. © 2002 by Excerpta Medica, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/78146
ISSN
2015 Impact Factor: 3.154
2015 SCImago Journal Rankings: 2.063
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLau, CPen_HK
dc.contributor.authorTse, HFen_HK
dc.contributor.authorNg, Wen_HK
dc.contributor.authorChan, KKen_HK
dc.contributor.authorLi, SKen_HK
dc.contributor.authorKeung, KKen_HK
dc.contributor.authorLau, YKen_HK
dc.contributor.authorChen, WHen_HK
dc.contributor.authorTang, YWen_HK
dc.contributor.authorLeung, SKen_HK
dc.date.accessioned2010-09-06T07:39:40Z-
dc.date.available2010-09-06T07:39:40Z-
dc.date.issued2002en_HK
dc.identifier.citationAmerican Journal Of Cardiology, 2002, v. 89 n. 2, p. 150-154en_HK
dc.identifier.issn0002-9149en_HK
dc.identifier.urihttp://hdl.handle.net/10722/78146-
dc.description.abstractAngiotensin-converting enzyme (ACE) inhibitors reduce mortality in patients with acute myocardial infarction (AMI), but these benefits might be limited by acute hemodynamic changes and difficulties in titrating to recommended doses. The objective of this study was to compare the hemodynamic changes and tolerability of perindopril with captopril after AMI. We randomized 212 patients to receive either captopril (n = 102) or perindopril (n = 110) within 72 hours of AMI. Captopril was given as an initial dose of 6.25 mg, and then 50 mg/day on day 1 and 100 mg/day thereafter. The corresponding doses of perindopril were 2, 4, and 8 mg/day. Acute hemodynamic changes, the percentage of patients who reached target doses, and in-hospital and 6-month cardiovascular events were monitored. Baseline clinical characteristics of the 2 groups were identical, but patients randomized to perindopril were in a higher Killip class (1.4 ± 0.6 vs 1.2 ± 0.5, p = 0.05). During the first 6 hours, treatment with perindopril resulted in higher minimal systolic (97 ± 15 vs 91 ± 14 mm Hg, p <0.01) and diastolic blood pressure (BP) (57 ± 11 vs 54 ± 10 mm Hg, p <0.02), later occurrence of minimal BP (3.6 ± 0.2 vs 2.7 ± 0.1 hour, p <0.001), and a lower incidence of persistent hypotension with systolic BP <90 mm Hg for ≥1 hour (5% vs 16%; p <0.01) compared with captopril. At initial administration, target doses of perindopril and captopril were attained in 97% and 82% of the patients, respectively (p <0.01). After 6 months, there were no differences between patients treated with perindopril and captopril in mortality rates (6% vs 13%, p = 0.16) and need for revascularization (20% vs 21%, p = 0.9). Thus, in patients during AMI, perindopril treatment showed better short-term tolerance than treatment with captopril, with significantly less acute hemodynamic changes and fewer withdrawals. © 2002 by Excerpta Medica, Inc.en_HK
dc.languageengen_HK
dc.publisherExcerpta Medica, Inc. The Journal's web site is located at http://www.ajconline.org/en_HK
dc.relation.ispartofAmerican Journal of Cardiologyen_HK
dc.subject.meshAgeden_HK
dc.subject.meshAngiotensin-Converting Enzyme Inhibitors - therapeutic useen_HK
dc.subject.meshCaptopril - therapeutic useen_HK
dc.subject.meshChi-Square Distributionen_HK
dc.subject.meshFemaleen_HK
dc.subject.meshHemodynamics - drug effectsen_HK
dc.subject.meshHumansen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshMyocardial Infarction - drug therapy - mortalityen_HK
dc.subject.meshPerindopril - therapeutic useen_HK
dc.subject.meshTreatment Outcomeen_HK
dc.titleComparison of perindopril versus captopril for treatment of acute myocardial infarctionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0002-9149&volume=89&spage=150&epage=154&date=2002&atitle=Comparison+of+perindopril+versus+captopril+for+treatment+of+acute+myocardial+infarction.en_HK
dc.identifier.emailTse, HF:hftse@hkucc.hku.hken_HK
dc.identifier.authorityTse, HF=rp00428en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0002-9149(01)02191-9en_HK
dc.identifier.pmid11792333-
dc.identifier.scopuseid_2-s2.0-0037081648en_HK
dc.identifier.hkuros74771en_HK
dc.identifier.hkuros100792-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0037081648&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume89en_HK
dc.identifier.issue2en_HK
dc.identifier.spage150en_HK
dc.identifier.epage154en_HK
dc.identifier.isiWOS:000173334600007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLau, CP=7401968501en_HK
dc.identifier.scopusauthoridTse, HF=7006070805en_HK
dc.identifier.scopusauthoridNg, W=7401613562en_HK
dc.identifier.scopusauthoridChan, KK=7406034649en_HK
dc.identifier.scopusauthoridLi, SK=8270281600en_HK
dc.identifier.scopusauthoridKeung, KK=6508135342en_HK
dc.identifier.scopusauthoridLau, YK=7201403303en_HK
dc.identifier.scopusauthoridChen, WH=7409637978en_HK
dc.identifier.scopusauthoridTang, YW=36794015900en_HK
dc.identifier.scopusauthoridLeung, SK=7202044902en_HK

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