Aspirin does not influence the effect of angiotensin-converting enzyme inhibition on left ventricular ejection fraction 3 months after acute myocardial infarction.
The aim of the present study was to evaluate the possible interaction between chronic aspirin therapy and angiotensin-converting enzyme inhibitor (ACE-I) on left ventricular ejection fraction (LVEF) in patients surviving an acute myocardial infarction (AMI). Forty-two patients with reduced LVEF were recruited from the warfarin aspirin reinfarction study (WARIS-II), a randomized, open study comparing enteric coated aspirin (160 mg/d), warfarin (INR 2.8--4.2) and the combination of aspirin (75 mg/d) and warfarin (INR 2.0--2.5) on mortality, reinfarction and stroke after AMI. LVEF and relevant biochemical measurements were performed before discharge and after 3 months. The overall LVEF increased during the study period from median 35 to 39% (P<0.001). There was no difference between patients on aspirin and warfarin regarding the main end point, LVEF. Furthermore, neither endothelin-1 nor ANP showed significant differences between the treatment groups. A possible interaction between ACE-I and aspirin might theoretically lead to reduced levels of renin activity in patients on aspirin, but we did not find any such inter-group difference. In conclusion, we did not find evidence of interaction between ACE-I and low-dose aspirin.
Department of Cardiology, Ullevål University Hospital, Oslo, Norway.
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M
Hurlen
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T
Hole
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I
Seljeflot
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H
Arnesen
D000328:Adult; D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage* / Q000009:adverse effects; D001241:Aspirin / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality; D012008:Recurrence; D012307:Risk Factors; D015996:Survival Rate; D016277:Ventricular Function, Left / Q000187:drug effects*; D014859:Warfarin / Q000008:administration & dosage* / Q000009:adverse effects
D000806:Angiotensin-Converting Enzyme Inhibitors; D014859:Warfarin; D001241:Aspirin