Many metabolic and hormonal changes are observed during the acute phase of
myocardial infarction (
glucose metabolism,
lipoproteins...).
Mineralocorticoid function may also be disturbed but there have been few studies of this problem. The aim of this study was to confirm the elevation of serum
aldosterone during the acute phase of
myocardial infarction and to determine the effects of antialdosterone treatment in these patients.
Hyperaldosteronism was confirmed in 74% of 72 consecutive patients admitted for acute
myocardial infarction, in 85% if patients previously treated by an antialdosterone
drug or admitted after the acute phase are excluded, and in 96% if patients with
cardiac failure are included. One thousand consecutive patients admitted for
myocardial infarction were given an antialdosterone agent systematically (intravenous
potassium canrenoate , 600 mg daily for 5 days). The serum and red blood cell
potassium concentrations rose, the number of
ventricular extrasystoles and the administration of
anti-arrhythmic drugs fell, and, above all, the prevalence of
ventricular fibrillation decreased significantly: 0,8% (p less than 0,001), compared with comparable previously reported series.