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THERAPY Does captopriJ enhance thrombolysis in acute MI? Imponant data on the effects of oral captopril staned during thrombolysis in acute anterior myocardial infarction have been provided by results from the Captopril and Thrombolysis Study (CATS). Researchers from the Dutch study conclude that. while some benefits are seen with this approach. left ventricular remodelling is not prevented. In a randomised. double-blind placebo-controlled trial. 298 patients with a first anterior MI of less than 6 hours duration received either oral captopril or placebo titrated to a dose of 25mg tid. initiated immediately on completion of streptokinase 1.5 million IV as a 30-minute infusion. Therapy with captopril or placebo was continued for 3 months. During the acute thrombolytic phase. nonsustained ventricular tachycardia and accelerated idioventricular rhythm was significantly less frequent in the captopril group. with a reduction of > 20% being observed. There was also a decrease in norepinephrine [noradrenaline] release initially. The left ventricular end-diastolic and end-systolic volume indices for the captopril group tended to be lower at all time intervals compared with the placebo group. although the overall difference during the 3 months of follOW-Up was not statistically significant. The incidence of hypotension during the titration phase was 14.8% in the placebo group and 22.3% in the captopril group. and 18.1 and 26.8%. respectively. during the follow-up period. Although there was no significant difference between the 2 treatment groups with regard to monality rate. the captopril group had a 34% lower incidence of hean failure. Kingma m. van Gilst WH. Peels CH. CATS Investigators. Acute intervention with captopril during thrombolysis in patients with first anterior myocardial iniarction. Results from the Captopril and Thrombolysis Study (CATS). European Heart Journal 15: 898-907. Jull994 "'""'.<3 0156·27031941095()'OOO191$01.00 C Adi. International Limited 1994. All righta reserved 19 INPHARMA 8 13 Aug 1994

Does captopril enhance thrombolysis in acute MI?

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Page 1: Does captopril enhance thrombolysis in acute MI?

THERAPY

Does captopriJ enhance thrombolysis in acute MI?

Imponant data on the effects of oral captopril staned during thrombolysis in acute anterior myocardial infarction have been provided by results from the Captopril and Thrombolysis Study (CATS). Researchers from the Dutch study conclude that. while some benefits are seen with this approach. left ventricular remodelling is not prevented.

In a randomised. double-blind placebo-controlled trial. 298 patients with a first anterior MI of less than 6 hours duration received either oral captopril or placebo titrated to a dose of 25mg tid. initiated immediately on completion of streptokinase 1.5 million IV as a 30-minute infusion. Therapy with captopril or placebo was continued for 3 months.

During the acute thrombolytic phase. nonsustained ventricular tachycardia and accelerated idioventricular rhythm was significantly less frequent in the captopril group. with a reduction of > 20% being observed. There was also a decrease in norepinephrine [noradrenaline] release initially.

The left ventricular end-diastolic and end-systolic volume indices for the captopril group tended to be lower at all time intervals compared with the placebo group. although the overall difference during the 3 months of follOW-Up was not statistically significant.

The incidence of hypotension during the titration phase was 14.8% in the placebo group and 22.3% in the captopril group. and 18.1 and 26.8%. respectively. during the follow-up period.

Although there was no significant difference between the 2 treatment groups with regard to monality rate. the captopril group had a 34% lower incidence of hean failure. Kingma m. van Gilst WH. Peels CH. CATS Investigators. Acute intervention with captopril during thrombolysis in patients with first anterior myocardial iniarction. Results from the Captopril and Thrombolysis Study (CATS). European Heart Journal 15: 898-907. Jull994 "'""'.<3

0156·27031941095()'OOO191$01.00C Adi. International Limited 1994. All righta reserved

19

INPHARMA8 13 Aug 1994