ACE inhibitiors have been recently used to treat the chronic congestive heart failure after the use of the antihypertensive agents.The enalapril was added to the chronic congestive heart failure patients unresponded to diuretics and digoxin. The echocardiography, serum chemical examinations, ECG, chest X-ray and clinical manifestations were done to the 47 patients with chronic severe congestive heart failure unresponded to diuretics and digoxin before and 2 months after the addition of enalapril between Feb. 1991 and Nov. 1991 in Dong-A Univerity Hospital. The results were followed : 1) The dyspnea, the hepatomegaly, the engorged jugular vein, cough, edema, palpitation, chest discomfort, and the tachycardia were improved 2 months after the treatment of enalapril. 2) The cardiomegaly and lung edema on the chest PA, and the elevated GOT, GPT and serum creatinine were improved 2 months after the treatment of enalapril. 3) Left ventricular end systolic dimension, fractional shortening, left ventricular end diastolic volume, and ejection time on the ECHO were significantly increased after 2 months of the treatment of enalapril. ACE inhibitor, enalapril revealed the effectiveness of the treatment to the patients with the severe congestive heart failure, and we should try to study the mortality rates to decrease compared with the control groups without the treatment of enalapril.
Cardiomegaly ; Cough ; Creatinine ; Digoxin ; Diuretics ; Dyspnea ; Echocardiography ; Edema ; Electrocardiography ; Enalapril* ; Estrogens, Conjugated (USP)* ; Heart Failure* ; Hepatomegaly ; Humans ; Jugular Veins ; Lung ; Mortality ; Stroke Volume ; Tachycardia ; Thorax

BACKGROUNDThe zotarolimus-eluting stent has shown larger in-stent late lumen loss compared to sirolimus-eluting stents in previous studies. However, this has not been thoroughly evaluated in ST elevation myocardial infarction.

METHODSThis was a prospective, randomized, controlled trial evaluating angiographic outcomes in patients presenting with ST elevation myocardial infarction, treated with zotarolimus-eluting stents or sirolimus-eluting stents. From March 2007 to February 2009, 122 patients were randomized to zotarolimus-eluting stents or sirolimus-eluting stents in a 1:1 fashion. The primary endpoint was 9-month in-stent late lumen loss confirmed by coronary angiography, and secondary endpoints were percent diameter stenosis, binary restenosis rate, major adverse cardiac events (a composite of cardiac death, non-fatal myocardial infarction, and target vessel revascularization), and late-acquired incomplete stent apposition.

RESULTSAngiographic in-stent late lumen loss was significantly higher in the zotarolimus-eluting stent group compared to the sirolimus-eluting stent group ((0.49 ± 0.65) mm vs. (0.10 ± 0.46) mm, P = 0.001). Percent diameter stenosis at 9-month follow-up was also larger in the zotarolimus-eluting stent group ((30.0 ± 17.9)% vs. (17.6 ± 14.0)%, P < 0.001). In-segment analysis showed similar findings. There were no significant differences in binary restenosis rate, major adverse cardiac events, and late-acquired incomplete stent apposition.

CONCLUSIONSCompared to sirolimus-eluting stents, the zotarolimus-eluting stent is associated with significantly higher in-stent late lumen loss at 9-month angiographic follow-up in the treatment of ST elevation myocardial infarction. Although there was no significant difference in 1-year clinical outcomes, the clinical implication of increased late lumen loss should be further studied.

Aged ; Angioplasty, Balloon, Coronary ; adverse effects ; methods ; Drug-Eluting Stents ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction ; therapy ; Sirolimus ; analogs & derivatives ; therapeutic use ; Treatment Outcome