Comments on: Microvascular Obstruction Remains a Portent of Adverse Remodeling in Optimally-Treated Patients with Left Ventricular Systolic Dysfunction After Acute Myocardial Infarction http://www.thepreparedminds.com/archives/1489 In the field of observation, chance favors the prepared minds. Sat, 04 Feb 2012 14:45:45 +0000 hourly 1 http://wordpress.org/?v=3.3 By: Jacobo Kirsch, MD http://www.thepreparedminds.com/archives/1489/comment-page-1#comment-1431 Jacobo Kirsch, MD Wed, 31 Mar 2010 16:44:27 +0000 http://www.thepreparedminds.com/?p=1489#comment-1431 One important comment by the authors is that "the presence or absence of late MO divided patients into two distinct groups: those with late MO adverse remodeled while those without late MO reverse remodeled despite a high revascularization rate and very high prescription of evidence-based anti-remodeling medications across the cohort." Another interesting finding highlighted by the authors is that "We found that MO was associated with significantly less remodeling in eplerenone- than in placebo-treated patients. This is of considerable interest, as the role of aldosterone antagonists on top of ACE inhibitors/ARBs and beta blockers in post-MI remodeling is still controversial. Our novel results support an anti- remodeling role for eplerenone in those at greatest risk of remodeling, i.e. those with MO." One important comment by the authors is that “the presence or absence of late MO divided patients into two distinct groups: those with late MO adverse remodeled while those without late MO reverse remodeled despite a high revascularization rate and very high prescription of evidence-based anti-remodeling medications across the cohort.”

Another interesting finding highlighted by the authors is that “We found that MO was associated with significantly less remodeling in eplerenone- than in placebo-treated patients. This is of considerable interest, as the role of aldosterone antagonists on top of ACE inhibitors/ARBs and beta blockers in post-MI remodeling is still controversial. Our novel results support an anti- remodeling role for eplerenone in those at greatest risk of remodeling, i.e. those with MO.”

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