Acute Myocardial Infarction When The Renin - Angiotensin - Aldosterone System Change And Its Effects Of Angiotensin Converting Enzyme Inhibitors

A series of plasma renin activity (PRA), serum angiotensin converting enzyme activity (ACE), concentrations of plasma angiotensin II (AII) and plasma aldosterone (Ald) were measured by raidoimmunoassay in 38 consecutive patients with acute myocardial infarction (AMI) or suspected AMI.The results showed: PRA, AII and Ald were elevated in twenty—one patients with confirmed AMI within one week after onset. PRA rose progressively over one week, and was significantly higher than those of non-AMI (n= 11) at the seventh day. Concentrations of plasma aldosterone also increased significantly on day 2 and day 7 in patients with AMI compared with those of non-AMI. Concentrations of plasma AII rose in cases both with or without AMI up to the third week. The level of mean ACE remained normal throughout the study period in all subjects. In those AMI complicated with cardiogenic shock, left ventricular failure, III° A-V block or severe ventricular arrythmias, renin activity, concentrations of AII and Ald increased comparing with those of uncomplicated-AMI patients. The peak values of creatine kinase (CPK) correlared well with the peak values of PRA, ACE, AII and Ald respectively. PRA...