Avtor/Urednik		Sinkovič, Andreja
Naslov		Age-related short-term effect of ramipril on N-terminal pro-brain natriuretic peptide and markers of hemostasis in patients after acute myocardial infarction
Tip		članek
Vir		Wien Klin Wochenschr Suppl
Vol. in št.		Letnik 122, št. 2
Leto izdaje		2010
Obseg		str. 74-8
Jezik		eng
Abstrakt		Background: Angiotensin-converting enzyme (ACE) inhibitors after acute myocardial infarction (MI) prevent heart failure and recurrent ischemic events. Our aim was to evaluate the effect of ramipril on N-terminal pro-brain natriuretic peptide (NT-proBNP) and on markers of hemostasis, including plasminogen-activator-inhibitor-1 (PAI-1), von Willebrand factor (vWF), factor VIII (FVIII) and fibrinogen, in patients after acute MI, with emphasis on those over 55 years of age. Methods: In this prospective, single-center, observational study 38 patients were treated with ramipril after the first Q-wave MI. Markers of hemostasis and NT-proBNP were estimated before and two weeks after ramipril treatment. Results: Significant differences were observed in PAI-1 and NT-proBNP levels in patients over 55 years. In this age group the mean PAI-1 level decreased significantly after ramipril therapy (3.6 +/- 1.25 U/ml vs. 2.65 +/- 1.4 U/ml, P=0.011) and was significantly lower than in younger (<55 years) patients (2.65 +/- 1.4 U/ml vs.4.39 +/- 1.7 U/ml, P=0.002). In addition, in the older patients the mean baseline NTproBNP level was significantly higher than in the younger age group (258.35 +/- 347.6 pmol/l vs. 17.1 +/- 22 pmol/l, P=0.028) and was also higher after ramipril therapy (240.5 +/- 254.3 pmol/l vs. 67.3 +/- 75.2 pmol/l, P=0.034). In the younger patients, mean NT-proBNP after short-term ramipril therapy increased significantly in comparison with baseline (67.3 +/- 75.2 pmol/l vs. 17.15 +/- 22.0 pmol/l, P=0.046). Conclusion: In acute Q-wave MI, increased PAI-1 levels, but not increased NT-proBNP, respond rapidly to early ACE inhibition by ramipril in patients over 55 years of age but not in younger patients.
Deskriptorji		MYOCARDIAL INFARCTION RAMIPRIL RAMIPRIL ANGIOTENSIN-CONVERTING ENZYME INHIBITORS PLASMINOGEN ACTIVATOR INHIBITOR 1