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Terapia farmacológica después del infarto agudo de miocardio

Authors: Aztiparte, J.;

Terapia farmacológica después del infarto agudo de miocardio

Abstract

El tratamiento después del infarto depende del riesgo del paciente. Se aconseja la aspi rina para los enfermos de bajo riesgo. Hay también una tendencia creciente a prescribir una "estatina" con el fin de mantener el nivel de colesterol por debajo de los 210 mgldL. La terapia estrogénica puede ser útil en las mujeres post-menopáusicas. Los betabloqueantes, en los pacientes de moderado riesgo, son beneficiosos puesto que reducen la muerte súbita y el reinfarto. El veraparnilo puede ser una alternativa cuando el betabloqueante no es bien tolerado. Los inhibidores ECA son beneficiosos en los pacientes de alto riesgo con disfunción sistólica del ventriculo izquierdo. Otros fármacos no son de beneficio probado -p. ej., los nitratos- o tienen efectos perjudiciales -p. ej., el nifedipino, el diltiazem en los pacientes con insuficiencia cardíaca y los antiarrítmicos de clase 1-. La arniodarona es el único fármaco que puede ser útil en los pacientes con arritmias ventriculares severas.

The treatment after myocardial infarction depends on the patient risk. Daily aspirine is advised for patients at low risk. There is also a growing tendency to prescribe an "statine" in order to mantain the cholesterol level below 210 mgldL. Estrogen therapy can be considered in post-menopausal women. 'Beta-blocker agents have a proved benefit for patients at moderate risk because they reduce sudden death and reinfarction. Veraparnil is an option when the beta-blocker can not be tolerated. Treatment with ACE inhibitors benefit patients with left ventricular systolic dysfunction. Other pharmacologic agents are of unproved benefit -eg, nitrates- or have harmful effects -eg, nifedipine, diltiazem in patients with heart failure and class 1 antiarrhythmic drugs-. Only arniodarone seems to be useful for patients with severe ventricular arryhthmias.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
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