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USMLE Step 1 Forum USMLE Step 1 Discussion Forum: Let's talk about anything related to USMLE Step 1 exam |
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#1
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Which one is better, ACEi or Beta blocker? In the case post myocardial infarct and to prevent remodelling of ventricle
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#2
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As far as I know, all post-MI patients are put on beta 1-blockers for the rest of their lives. If the left ventricular function is normal there is no need for ACE inhibitors. I think everybody gets started on ACE inhibitors and they check to see if the LV function is normal 6 months after an MI.
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#3
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Direct comparisons indicate that carvedilol has a similar safety and tolerability profile to ACE-inhibitors and thereby support the feasibility of administering this drug as first-line therapy in selected patients with mild to moderate chronic heart failure. Therefore, the decision to initiate treatment with carvedilol or an ACE-inhibitor might in future be tailored on an individual basis and followed thereafter by combination therapy at the earliest and safest opportunity. Finally, the possible development of treatment strategies addressing the cellular and molecular mechanisms responsible for the remodeling process and the recently published benefits of device therapies herald a combined, synergistic approach to the future management of heart failure.
http://www.ncbi.nlm.nih.gov/pubmed/12783070 |
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