Abbildung 4: KHK - Sekundärprävention
The rationale of the possible benefits of an ACEI in the treatment of coronary artery disease is based on their anti ischemic properties linked to their mode of action. Angiotensin II (A II) plays a significant role in the mechanisms which underlie the atherosclerotic process: vasoconstriction and cell proliferation. Angiotensin-converting enzyme (ACE) inhibitors, such as perindopril, interrupt the production of A II, leading to antiproliferative and anti atherogenic effect. On the other hand, ACE inhibitors counteract the breakdown of bradykinin. A substance, which is responsible for the improvement in endothelial function, leading to vasodilation and growth inhibition. Bradykinin stimulates nitric oxide (NO) production and prostaglandin release from the endothelium. NO production and prostaglandin release yield beneficial vasodilatory, growth-inhibitory, antiatherogenic, antithrombotic, anti-inflammatory, and antioxidant effects.