BLOCANŢII RECEPTORILOR PENTRU ANGIOTENSINĂ I ŞI II ŞI REZULTATELE CARDIOVASCULARE.

Blockade of the renin-angiotensin system has become one of the most successful therapeutic approaches in recent years, leading to a decrease in cardiovascular morbidity and mortality in patients with chronic heart failure as well as in patients with myocardial infarction. Multiple well-known randomized clinical trials have established the value of the angiotensin-converting enzyme inhibitors at these patients. Several more recent trials have compared combination therapy with angiotensin receptor blockers and angiotensin-converting enzyme inhibitors with the respective monotherapies in patients with MI and in patients with chronic heart failure. In contrast to the most recent trials involving patients with chronic heart failure (CHARM-Added and Val-HeFT) in which dual renin-angiotensin system blockade was shown to be beneficial in terms of cardiovascular morbidity and mortality, VALIANT trial failed to demonstrate the superiority of combination therapy in improving survival in patients with acute myocardial infarction complicated with heart failure. Some experimental and clinical studies associate angiotensin II AT1 receptor blockers therapy with an unexplained increase in myocardial infarction, but several rigorous meta-analyses did not confirm this hypothesis. The dual renin-angiotensin system blockade has proved its beneficial effect on the improvement of the left ventricular function, without increasing all-cause mortality, cardiovascular mortality and morbidity. [ABSTRACT FROM AUTHOR]