山梨医科大学雑誌　第10巻3号　091-098(1995)

Clinical Study of Delapril Hydrochloride in Patients
with Acute Myocardial Infarction:
Effects of Early ACE Inhibition foflowing Effective
Thrombofytic Coronary Recanalizati

Atsushi SUGIYAMA, Kiyoshi INOUE, Yoshio MUKAIYAMA and Keitaro HASHIMOTO

Abstract: The present study investigated the effects of a new angiotensin-converting enzyme inhibitor, delapril hydrochloride, on left ventricular dysfunction in patients with acute myocardial infarction (AMI). Ten patients admitted within 24 hr after the onset of AMI symptoms who had undergone successful thrombolytic coronary recanalization, were randomized to either the delapril group (n=5) or the control group (n=5). Groups were comparable in terms of age, gender, heart rate, blood pressure, inclusion time, infarct location and max CPK. The administration of delapril (15 mg p.o., every 12 hr) was started within 24 hr after randomization. Left ventriculography was performed immediately and 4 weeks after admission to assess global and local ventricular contractility. Both the delapril group and the control group showed significant improvement over the 4 weeks in both global ejection fraction and local impaired ventricular wall motion "stunned" by ischemic episode. However, the increments of both variables in the delapril group were somewhat greater. Delapril was well tolerated by all patients, and symptomatic hypotension or untoward clinical effect was not observed. There were no adverse hematological or biochemical effects detected. These results suggest that delapril could become a good candidate for a large-scale phase III clinical trial for the treatment of left ventricular dysfunction following effective thrombolytic recanalization.

Key words: delapril, ACE inhibitor, acute myocardial infarction, remodeling, stunning




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