Table 3.
Effects of angiotensin converting enzyme (ACE) inhibitors on myocardial infarction in patients with low ejection fraction
| Trial | Patient characteristics | No (%) with myocardial infarction
|
% Reduction in relative risk (95% CI) |
P value | |
|---|---|---|---|---|---|
| ACE inhibitor | Placebo | ||||
| Acute infarction ramipril efficacy (AIRE)30 | Clinical evidence of heart failure soon after infarct | 81 (8.0) | 88 (8.9) | 9 (−22 to 35)* | >0.05 |
| Trandolapril cardiac evaluation study (TRACE)31 | Left ventricular ejection fraction ⩽35% soon after infarct | 97 (11.1) | 111 (12.7) | 14 (−10 to 31) | >0.05 |
| Studies of left ventricular dysfunction (SOLVD)32: | |||||
| Prevention | Left ventricular ejection fraction ⩽35% without heart failure | 161 (7.6) | 204 (9.1) | 24 (6 to 38) | 0.01 |
| Treatment | Left ventricular ejection fraction ⩽35% with heart failure | 127 (9.9) | 158 (12.3) | 23 (2 to 39) | 0.02 |
| Survival and ventricular enlargement trial (SAVE)33 | Left ventricular ejection fraction ⩽40% soon after infarct | 133 (11.9) | 170 (15.2) | 25 (5 to 40) | 0.05 |
| Total | 23 (11 to 32) | ||||
*
Long term follow up of the UK component of AIRE (AIREX) showed a significant reduction in fatal myocardial infarctions.