Vascular Biology in Clinical Practice © Vol. 4, No. 3
• Peri-interventional care: Rationale for ACE manipulation
This monograph, Peri-interventional care: Rationale for ACE manipulation, is offered as part of a series of continuing medical education programs from the University of Florida College of Medicine.
Co-editors are Carl J. Pepine, MD, University of Florida College of Medicine and Jerome D. Cohen, MD, Saint Louis University School of Medicine.
Intensive secondary-prevention strategies directed to the vascular wall are essential to promote plaque stability and reduce the risk of future ischemic events in the peri-interventional patient. New guidelines advise the use of angiotensin-converting enzyme (ACE) inhibitors within a total management strategy. Acting through multiple mechanisms, ACE inhibitors demonstrate plaque-stabilizing capabilities that likely contribute to their proven efficacy in reducing recurrent coronary events. These effects are in addition to those of lipid-lowering drugs and other concomitant medications. This monograph discusses the scientific rationale for ACE manipulation in the peri-interventional patient and summarizes studies that demonstrate the efficacy of ACE inhibition in patients with acute coronary syndromes. Also discussed are recent trials that suggest a role for ACE inhibition in reducing morbidity and mortality in high-risk patients.