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Details for Patent: 5,977,160

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Details for Patent: 5,977,160

Title: Methods for reducing risk of repeat myocardial infarction and increasing survival in heart attack victims
Abstract:The invention involves a method for treating a human survivor of a heart attack and provides further improvement in survival following the heart attack by the early initiation and long-term administration of an angiotensin converting enzyme inhibitor. The angiotensin converting enzyme inhibitor may be used on its own, or in conjunction with other therapeutic compounds such as data blockers and thrombolytic agents. The preferred angiotensin converting enzyme inhibitor is captopril.
Inventor(s): Pfeffer; Marc A. (Chestnut Hill, MA), Pfeffer; Janice M. (Chestnut Hill, MA), Braunwald; Eugene (Weston, MA)
Assignee: Brigham and Women's Hospital, Inc. (Boston, MA)
Filing Date:Apr 10, 1992
Application Number:07/866,827
Claims:1. A method for treating a human survivor of a myocardial infarction who is free of hypertension and congestive heart failure and is otherwise free of indications for angiotensin-converting enzyme inhibition treatment to prevent repeat myocardial infarction and to increase the likelihood of survival following the myocardial infarction, comprising:

administering to the human survivor who is free of hypertension and congestive heart failure and is otherwise free of indications for angiotensin converting enzyme inhibition treatment a therapeutically-effective amount of an angiotensin-converting enzyme inhibitor wherein the human survivor has a left ventricular ejection fraction of less than or equal to 40% after the myocardial infarction.

2. A method for treating a human survivor of a myocardial infarction as claimed in claim 1 wherein the angiotensin converting enzyme inhibitor is administered for an extended period of time.

3. A method for treating a human survivor of a myocardial infarction as claimed in claim 1 wherein the angiotensin converting enzyme inhibitor is administered to the human survivor within 16 days of myocardial infarction.

4. A method for treating a human survivor of a myocardial infarction as claimed in claim 1 wherein the angiotensin converting enzyme inhibitor is administered to the human survivor only after 3 days have passed since the myocardial infarction.

5. A method for treating a human survivor of a myocardial infarction as claimed in claim 1 wherein the angiotensin converting enzyme inhibitor is administered to the human survivor within 16 days of the myocardial infarction, but only after three days have passed since the myocardial infarction, and wherein the angiotensin converting enzyme inhibitor is administered for an extended period to the survivor.

6. A method for treating a human survivor of a myocardial infarction as claimed in claim 1 wherein the angiotensin converting enzyme inhibitor is administered at a lower dose at the start of treatment and at a higher dose after the start of treatment.

7. A method for treating a human survivor of a myocardial infarction as claimed in claim 6 wherein the higher dose is the maximum dose tolerable.

8. A method for treating a human survivor of a myocardial infarction as claimed in claim 1 wherein the angiotensin converting enzyme inhibitor is administered three times per day.

9. A method for treating a human survivor of a myocardial infarction as claimed in claim 1 wherein the angiotensin converting enzyme inhibitor is administered for at least two years.

10. A method for treating a human survivor of a myocardial infarction as claimed in claim 1 wherein the angiotensin converting enzyme inhibitor is captopril and wherein the captopril is administered at a lower dose at the start of treatment and at a higher dose after the start of treatment and wherein the lower dose is less than 20 mg per day and wherein the higher dose is not more than about 150 mg per day.

11. A method for treating a human survivor of a myocardial infarction as claimed in claim 1 wherein the angiotensin converting enzyme inhibitor is captopril and the captopril is administered to the human survivor only after three days have passed since the myocardial infarction, wherein the captopril is administered at a lower dose at the start of treatment and at a higher dose after the start of treatment and wherein the captopril is administered at an initial dose of about 6.25 mg, three times per day, a first intermediate dose of about 12.5 mg, three times per day, a second intermediate dose of about 25 mg, three times per day, and a final dose of a tolerable amount up to about 50 mg, three times per day.

12. A method for treating a human survivor of a myocardial infarction as claimed in claim 1 wherein the angiotensin converting enzyme inhibitor is administered at the maximum dose tolerable.

13. A method for treating a human survivor of a myocardial infarction as claimed in any one of claims 1, 2, 3, 4, 5, 6, 7, 8, 9, and 12, wherein the angiotensin converting enzyme inhibitor is captopril.
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