World Journal of Emergency Medicine ›› 2013, Vol. 4 ›› Issue (1): 48-53.doi: 10.5847/wjem.j.issn.1920-8642.2013.01.009
• Original Articles • Previous Articles Next Articles
Chun-tao Wu1, Zhong-hua Wang2, Zhu-qin Li2, Lan-feng Wang2()
Received:
2012-09-19
Accepted:
2013-01-11
Online:
2013-03-15
Published:
2013-03-15
Contact:
Lan-feng Wang
E-mail:lanfengwang@hotmail.com
Chun-tao Wu, Zhong-hua Wang, Zhu-qin Li, Lan-feng Wang. Effect of spironolactone on cardiac remodeling after acute myocardial infarction[J]. World Journal of Emergency Medicine, 2013, 4(1): 48-53.
Add to citation manager EndNote|Ris|BibTeX
URL: http://wjem.com.cn//EN/10.5847/wjem.j.issn.1920-8642.2013.01.009
Table 1
Characteristics of the study population at baseline
Variables | Control group (n=266) | Treatment group (n=262) | t /χ2 | P |
---|---|---|---|---|
Age (y) | 59.9±10.3 | 59.8±11.7 | 0.1042 | >0.05 |
Male/Female | 192/74 | 193/69 | 0.1471 | 0.7013 |
Past medical history (n, %) | ||||
Hypertension | 117 (44) | 123 (47) | 0.4669 | 0.4944 |
Diabetes mellitus | 53 (20) | 50 (19) | 0.0594 | 0.8074 |
Hypercholesterolemia | 85 (32) | 76 (29) | 0.5410 | 0.4620 |
Current smoker | 136 (51) | 141 (54) | 0.3827 | 0.5362 |
Earlier angina | 64 (24) | 60 (23) | 0.0987 | 0.7534 |
Admission state (n, %) | ||||
Heart failure | 4 (1.5) | 4 (1.4) | 0.1120 | 0.7379 |
Blood pressure (mmHg) | ||||
Systolic | 118.3±9.8 | 117.2±10.3 | 1.2573 | 0.2092 |
Diastolic | 72.5±5.5 | 73.2±5.7 | 1.4361 | 0.1516 |
Infarction location (n, %) | ||||
Anterior wall (±lateral wall) | 140 (52.6) | 137 (52.3) | 0.0062 | 0.9374 |
Inferior wall (±posterior wall) | 126 (47.4) | 125 (47.7) | 0.0062 | 0.9374 |
Baseline therapies (n, %) | ||||
Thrombolysis | 76 (28.5) | 79 (30) | 0.1591 | 0.6900 |
PCI | 99 (37.4) | 116 (44.1) | 2.7230 | 0.0989 |
Time from symptom onset to recanalization (h) | 5.8±3.1 | 5.4±2.9 | 1.5306 | 0.1265 |
No recanalization treatment | 93 (35) | 100 (38) | 0.5848 | 0.4444 |
Standard therapy (n, %) | ||||
ACEI / ARB | 250 (94) | 246 (94) | 0.0020 | 0.9647 |
Beta-blockers | 247 (93) | 247 (99) | 0.4403 | 0.5070 |
Statins | 247 (92.9) | 246 (93.9) | 0.2289 | 0.6324 |
Aspirin | 261 (98.2) | 258 (98.3) | 0.0005 | 0.9817 |
Clopidogrel | 250 (94) | 252 (96) | 1.3624 | 0.2431 |
Time from AMI to study drug (h) | — | 17.1±3.8 | — | — |
Table 2
Correlation analysis of chest compression quality indexes
SRFT (mm) | Control group (n=266) | Treatment group (n=262) | Inter-group comparison at 12 mon | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
1 mon | 12 mon | t | P | 1 mon | 12 mon | t | P | t | P | |||
LVESD | 40.4±5.10 | 40.2±5.50 | 0.43 | 0.66 | 40.8±6.70 | 35.7±4.60 | 10.16 | <0.05 | 10.204 | <0.05 | ||
LVEDD | 53.2±5.71 | 52.8±5.54 | 0.82 | 0.41 | 53.4±6.60 | 51.1±5.40 | 4.37 | <0.05 | 3.5699 | 0.0004 | ||
IVST | 10.48±1.38 | 10.52±1.47 | 0.32 | 0.75 | 10.35±1.87 | 10.42±1.62 | 0.46 | >0.05 | 0.743 | 0.4578 | ||
LVPWT | 10.35±1.18 | 10.42±1.21 | 0.68 | 0.50 | 10.24±1.25 | 10.50±1.09 | 2.54 | <0.05 | 0.7978 | 0.4253 | ||
LVEF (%) | 50.12±11.34 | 52.35±12.01 | 2.20 | 0.03 | 52.05±12.08 | 54.86±11.69 | 2.71 | 0.0070 | 2.433 | 0.0153 | ||
LAD-ML | 39.84±5.20 | 39.94±5.10 | 0.22 | 0.82 | 39.23±5.65 | 38.24±5.05 | 2.12 | 0.0349 | 3.8483 | 0.0001 | ||
LAD-SI | 50.45±4.25 | 50.10±4.11 | 0.97 | 0.33 | 48.1±5.20 | 49.1±5.10 | 2.22 | 0.0267 | 2.4786 | <0.05 | ||
RAD-ML | 40.32±6.45 | 39.87±6.33 | 0.81 | 0.42 | 40.48±6.23 | 40.14±6.17 | 0.63 | 0.5305 | 0.4962 | 0.6199 | ||
RAD-SI | 46.87±3.11 | 47.09±3.07 | 0.82 | 0.41 | 46.88±3.06 | 47.12±3.12 | 0.90 | 0.3744 | 0.1114 | 0.9114 |
Table 3
Plasma concentrations of potassium and creatinine at 1-month and 12-month follow-up respectively
SRFT | Control group (n=266) | Treatment group (n=262) | |||||||
---|---|---|---|---|---|---|---|---|---|
1 mon | 12 mon | t | P | 1 mon | 12 mon | t | P | ||
Serum creatinine (μmol/L) | 88.75±18.03 | 87.59±17.97 | 0.7432 | 0.4577 | 87.53±17.78 | 88.4±16.81 | 0.602 | 0.5474 | |
Serum potassium (mmol/L) | 4.09±0.24 | 4.10±0.30 | 0.4245 | >0.05 | 4.08±0.25 | 4.11±0.29 | 1.2683 | >0.05 |
1 |
Furlan D, Sahnane N, Mazzoni M, Pastorino R, Carnevali I, Stefanoli M, et al. Diagnostic utility of MS-MLPA in DNA methylation profiling of adenocarcinomas and neuroendocrine carcinomas of the colon-rectum. Virchows Arch. 2012 Dec 9. [Epub ahead of print]
pmid: 33161462 |
2 |
Bousquet E, Zhao M, Ly A, Leroux Les Jardins G, Goldenberg B, et al. The aldosterone-mineralocorticoid receptor pathway exerts anti-inflammatory effects in endotoxin-induced uveitis. PLoS One 2012; 7:e49036.
pmid: 23152847 |
3 |
Roscioni SS, de Zeeuw D, Bakker SJ, Lambers Heerspink HJ. Management of hyperkalaemia consequent to mineralocorticoid-receptor antagonist therapy. Nat Rev Nephrol 2012; 8:691-699.
pmid: 23070570 |
4 |
No authors listed. Myocardial infarction redefined - a consensus document of the Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction. Eur Heart J 2000; 21:1502-1513.
doi: 10.1053/euhj.2000.2305 pmid: 10973764 |
5 | Li WX, Kong X, Zhang JX, Yang JR. Long-term intake of sesamin improves left ventricular remodelling in spontaneously hypertensive rats. Food Funct 2012 Dec 14. [Epub ahead of print] |
6 | Jugdutt BI. Matrix metalloproteinases as markers of adverse remodeling after myocardial infarction. Card Fail 2006; 12:73-76. |
7 | Vatankulu MA, Bacaksız A, Sonmez O, Alıhanoglu Y, Koc F, Demır K, et al. Does Spironolactone Have a Dose-Dependent Effect on Left Ventricular Remodeling in Patients with Preserved Left Ventricular Function After an Acute Myocardial Infarction? Cardiovasc Ther. 2012 Sep 11. |
8 | Nagata K. Mineralocorticoid antagonism and cardiac hypertrophy. Curr Hypertens Rep 2008; 10:216-221. |
9 | Fiebeler A, Schmidt F, Müller DN, Park JK, Dechend R, Bieringer M, et al. Mineralocorticoid receptor affects AP-1 and nuclear factor-kappab activation in angiotensin II-induced cardiac injury. Hypertension 2001; 37(2 Part 2):787-793. |
10 | Hayashi M, Tsutamoto T, Wada A, Tsutsui T, Ishii C, Ohno K, et al. Immediate administration of mineralocorticoid receptor antagonist spironolactone prevents post-infarct left ventricular remodeling associated with suppression of a marker of acute myocardial collagen synthesis in patients with first anterior acute myocardial infarction. Circulation 2003; 107:2559-2265. |
11 |
Struthers AD. The clinical implications of aldosterone escape in congestive heart failure. Eur J Heart Fail 2004; 6:539-545.
pmid: 15301999 |
12 |
Kawazu T, Nishino T, Obata Y, Furusu A, Miyazaki M, Abe K, et al. Production and degradation of extracellular matrix in reversible glomerular lesions in rat model of habu snake venom-induced glomerulonephritis. Med Mol Morphol 2012; 45:190-198.
pmid: 23224597 |
13 | Greco C, Castelli G, Crea F, Gavazzi A, Gensini GF, Scherillo M, et al. New evidences on the use of aldosterone receptor antagonists in left ventricular dysfunction. From myocardial infarction to heart failure. G Ital Cardiol (Rome) 2012; 13:809-816. |
14 |
Giallauria F, Galizia G, Lucci R, D'Agostino M, Vitelli A, Maresca L, et al. Favourable effects of exercise-based cardiac rehabilitation after acute myocardial infarction on left atrial remodeling. Int J Cardiol 2009; 136:300-306.
pmid: 18676038 |
15 | Milliez P, Deangelis N, Rucker-Martin C, Leenhardt A, Vicaut E, Robidel E, et al. Spironolactone reduces fibrosis of dilated atria during heart failure in rats with myocardial infarction. Eur Heart J 2005; 26:2193-2199. |
16 | Danzmann LC, Bodanese LC, Köhler I, Torres MR. Left atrioventricular remodeling in the assessment of the left ventricle diastolic function in Patients with heart failure: a review of the currently studied echocardiographic variables. Cardiovasc Ultrasound 2008; 6:56. |
17 |
Savoye C, Equine O, Tricot O, Nugue O, Segrestin B, Sautière K, et al. Left ventricular remodeling after anterior wall acute myocardial infarction in modern clinical practice (from the REmodelage VEntriculaire [REVE] study group). Am J Cardiol 2006; 98: 1144-1149. Epub 2006 Aug 31.
doi: 10.1016/j.amjcard.2006.06.011 pmid: 17056315 |
18 | Kayrak M, Bacaksiz A, Vatankulu MA, Ayhan SS, Ari H, Kaya Z, et al. The effects of spironolactone on atrial remodeling in patients with preserved left ventricular function after an acute myocardial infarction: a randomized follow-up study. Coron Artery Dis 2010; 21:477-485. |
[1] | Kun Cui, You-quan Shi, Yuan-zheng Zhang, Zheng-gong Li, Chang-ling Li. Optimized strategy of rotational atherectomy of underexpanded coronary stents in patients with acute coronary syndrome [J]. World Journal of Emergency Medicine, 2021, 12(3): 198-201. |
[2] | Yu-qing Cui, Xian-fei Ding, Huo-yan Liang, Dong Wang, Xiao-juan Zhang, Li-feng Li, Quan-cheng Kan, Le-xin Wang, Tong-wen Sun. Efficacy and safety of low-dose corticosteroids for acute respiratory distress syndrome: A systematic review and meta-analysis [J]. World Journal of Emergency Medicine, 2021, 12(3): 207-213. |
[3] | Hao-tian Chen, Jian-feng Xu, Xiao-xia Huang, Ni-ya Zhou, Yong-kui Wang, Yue Mao. Blood eosinophils and mortality in patients with acute respiratory distress syndrome: A propensity score matching analysis [J]. World Journal of Emergency Medicine, 2021, 12(2): 131-136. |
[4] | Ning Dong, Zhe-xi Lu, Xing-liang Li, Wei Li, Li Pang, Ji-hong Xing. Clinical correlates of hypotension in patients with acute organophosphorus poisoning [J]. World Journal of Emergency Medicine, 2021, 12(1): 24-28. |
[5] | Jing-jing Xu, Ying Song, Ping Jiang, Lin Jiang, Xue-yan Zhao, Zhan Gao, Jian-xin Li, Shu-bin Qiao, Run-lin Gao, Yue-jin Yang, Yin Zhang, Bo Xu, Jin-qing Yuan. Effects of metabolic syndrome on onset age and long-term outcomes in patients with acute coronary syndrome [J]. World Journal of Emergency Medicine, 2021, 12(1): 36-41. |
[6] | Tian Xu, Ya Li, Li-ding Zhao, Guo-sheng Fu, Wen-bin Zhang. Predictors of recurrent angina in patients with no need for secondary revascularization [J]. World Journal of Emergency Medicine, 2021, 12(1): 42-47. |
[7] | Yi Han, Su-cheng Mu, Jian-li Wang, Wei Wei, Ming Zhu, Shi-lin Du, Min Min, Yun-jie Xu, Zhen-ju Song, Chao-yang Tong. MicroRNA-145 plays a role in mitochondrial dysfunction in alveolar epithelial cells in lipopolysaccharide-induced acute respiratory distress syndrome [J]. World Journal of Emergency Medicine, 2021, 12(1): 54-60. |
[8] | Yu-ming Wang, Yan-jun Zheng, Ying Chen, Yun-chuan Huang, Wei-wei Chen, Ran Ji, Li-li Xu, Zhi-tao Yang, Hui-qiu Sheng, Hong-ping Qu, En-qiang Mao, Er-zhen Chen. Effects of fluid balance on prognosis of acute respiratory distress syndrome patients secondary to sepsis [J]. World Journal of Emergency Medicine, 2020, 11(4): 216-222. |
[9] | Muhammad Akhter Hamid, Ruqiya Afroz, Uqba Nawaz Ahmed, Aneela Bawani, Dilnasheen Khan, Rabia Shahab, Asim Salim. The importance of visualization of appendix on abdominal ultrasound for the diagnosis of appendicitis in children: A quality assessment review [J]. World Journal of Emergency Medicine, 2020, 11(3): 140-144. |
[10] | Guo-xiong Chen, Hong-na Wang, Jin-lin Zou, Xiao-xu Yuan. Effects of intracoronary injection of nicorandil and tirofiban on myocardial perfusion and short-term prognosis in elderly patients with acute ST-segment elevation myocardial infarction after emergency PCI [J]. World Journal of Emergency Medicine, 2020, 11(3): 157-163. |
[11] | Yun-fei Jiang, Jian Kang, Pei-pei Huang, Jia-xi Yao, Zhong-he Wang, Lei Jiang, Jun Wang, Li Qiao, Bao-li Zhu, Hao Sun, Jin-song Zhang. Evaluation of gastric lavage efficiency and utility using a rapid quantitative method in a swine paraquat poisoning model [J]. World Journal of Emergency Medicine, 2020, 11(3): 174-181. |
[12] | Wen-peng Yin, Jia-bao Li, Xiao-fang Zheng, Le An, Huan Shao, Chun-sheng Li. Effect of neutrophil CD64 for diagnosing sepsis in emergency department [J]. World Journal of Emergency Medicine, 2020, 11(2): 79-86. |
[13] | Jun Jiang, Nai-liang Tian, Han-bin Cui, Chang-ling Li, Xian-bao Liu, Liang Dong, Yong Sun, Xiao-min Chen, Shao-liang Chen, Bo Xu, Jian-an Wang. Post-dilatation improves stent apposition in patients with ST-segment elevation myocardial infarction receiving primary percutaneous intervention: A multicenter, randomized controlled trial using optical coherence tomography [J]. World Journal of Emergency Medicine, 2020, 11(2): 87-92. |
[14] | Hong-yi Wu, Ju-ying Qian, Qi-bing Wang, Jun-bo Ge. An unexpected electrocardiogram sign of subacute left ventricular free wall rupture: Its early awareness may be lifesaving [J]. World Journal of Emergency Medicine, 2020, 11(2): 117-119. |
[15] | Yi-wen Fan, Shao-wei Jiang, Jia-meng Chen, Hui-qi Wang, Dan Liu, Shu-ming Pan, Cheng-jin Gao. A pulmonary source of infection in patients with sepsis-associated acute kidney injury leads to a worse outcome and poor recovery of kidney function [J]. World Journal of Emergency Medicine, 2020, 11(1): 18-26. |
Viewed | ||||||
Full text |
|
|||||
Abstract |
|
|||||