Angiotensin II receptor antagonists in acute coronary syndromes. (2nd December 2013)

• Record Type: Journal Article
• Authors: Artom, Nathan; Montecucco, Fabrizio; Mach, François; Dallegri, Franco; Pende, Aldo
• Is Part Of: European journal of clinical investigation. Volume 44:Number 2(2014:Feb.)
• Page Start: 219
• Page End: 230
• Publication Date: 2013-12-02
• Subjects: Pathology -- Periodicals; Medical research -- Periodicals; 616.075
• DOI: 10.1111/eci.12198
• Languages: English
• ISSNs: 0014-2972

Abstract

<abstract abstract-type="main" id="eci12198-abs-0001"> <title>Abstract</title> <sec id="eci12198-sec-0001" sec-type="section"> <title>Background</title> <p>It is well known that inappropriate or exaggerated activity of the renin‐angiotensin system might contribute to the development of systemic hypertension with consequent organ injury and associated increased risk of acute cardiovascular (CV) diseases. This review will discuss evidence form basic research and clinical studies, investigating the efficacy of angiotensin II receptor blockers (ARBs) in the management of acute coronary syndromes (ACS).</p> </sec> <sec id="eci12198-sec-0002" sec-type="section"> <title>Materials and methods</title> <p>This narrative review is based on the material found on MEDLINE and PubMed up to June 2013. We looked for the terms 'angiotensin, AT1 receptor, ACE inhibitors' in combination with 'acute coronary syndromes, acute myocardial infarction, pathophysiology'.</p> </sec> <sec id="eci12198-sec-0003" sec-type="section"> <title>Results</title> <p>Preclinical studies showed relevant protective effects of ARBs to reduce adverse cardiac remodelling in animal models of acute cardiac ischaemia. However, although recommended in Consensus guidelines as a good alternative to angiotensin‐converting enzyme inhibitors (ACEIs), clinical studies did not confirm a superior efficacy of the ARBs as compared to ACEIs. As a matter of fact for some authors, these drugs might potentially have deleterious effects increasing the CV risk.</p> </sec> <sec id="eci12198-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Emerging evidence from clinical trials suggests that the use of ARBs in ACS might be controversial, and caution should be used for their clinical use to replace ACEIs in ACS.</p> </sec> </abstract>