RAS inhibitors in patients with acute myocardial infarction application of choice.docVIP

 PAGE \* MERGEFORMAT 14 RAS inhibitors in patients with acute myocardial infarction application of choice Renin - angiotensin system (renin  angiotensin system, RAS) activation is acute myocardial infarction (acute myocardial infarction, AMI) in patients with pathological physiology of the most important one of the reactions. Early enough inhibition of RAS, for the relief of left ventricular remodeling, protecting cardiac function and eventually to reduce mortality and mortality in patients with AMI has important clinical significance. In which ACE inhibitors have such a heart protective effect of large prospective randomized clinical research institute confirmed. In recent years, put into clinical use of angiotensin Ⅱ type 1 receptor antagonist (angiotensin Ⅱ type 1 receptor blockers, ARB), who can simultaneously block ACE and non-ACE pathway of angiotensin Ⅱ , and without ACE inhibitors cough, angioneurotic edema and other adverse reactions, from the theory and the protective effect of ACE inhibitors in the heart of equivalent or even superior to ACE inhibitors. Is that really the case? In AMI patients, ARB preferred, or whether it should completely replace the ACE inhibitor or ARB should be used in combination with ACE inhibitors? This paper on these issues, review recent published literature, do a brief overview. 1 AMI patients with ARB and ACE inhibitors, a direct comparison of Early mortality trials, there are two studies of the ARB and the effective dose of captopril (50mg, tid) were compared directly (head  to  head comparison) [1,2]. Which OPTIMAAL test (The Optimal Therapy in Myocardial Infarction With the Angiotensin Ⅱ Antagonist Losartan) selection of the 5477 cases of AMI patients, losartan dosage ELITE trials of chronic heart failure (chronic heart failure, CHF) in patients with proven effective dose, 50mg qd [1]. Another experiment VALIANT (The Valsartan in Acute Myocardial Infarction) selection of the 14,703 cases of AMI patients