[Effect of chronic therapy with low dose of angiotensin converting enzyme inhibitors on mortality in patients with left ventricular dysfunction after acute myocardial infarction].
Angiotensin converting enzyme inhibitors (ACE-I) used in patients with postinfarction left ventricular dysfunction reduce the risk of death. Some patients do not tolerate high dose of medications which benefit was well documented in multicentre trials.


OBJECTIVE
was to evaluate the effect of low doses of ACE-I on mortality rate in patients with ejection fraction (EF) below < or = 35% after acute myocardial infarction (MI) in long-term observation.


METHODS
Study population consisted of 84 patients (pts) (67 men and 17 women) aged 38-79 (mean age 61 +/- 11) years with post-MI left ventricular dysfunction (EF < or = 35%). Patients were divided into 2 groups according to applied treatment: the group ACE-I (+) - 50 pts who received captopril, enalapril, trandolapril, perindopril or quinapril at doses not exceeding half of target dose in chronic heart failure and the group ACE-I (-) - 34 pts not treated with ACE-I. The end point of this observation was total mortality during 48 month follow-up.


RESULTS
During long-term observation 33 from 84 patients died (39%). Mortality from all causes in the group ACE-I (+) was non significantly reduced as compared with the group ACE-I (-) (36% vs. 44%).


CONCLUSIONS
In patients with left ventricular dysfunction (EF < or = 35%) after acute myocardial infarction chronic treatment with low doses of ACE-I do not reduce total mortality rate.
Ruta
Jan
J
Uniwersytet Medyczny w Lodzi, Zakład Kardiologii Inwazyjnej. rutajan@interia.pl
Ptaszyński
Paweł
P
Maciejewski
Marek
M
Goch
Jan Henryk
JH
Chizyński
Krzysztof
K
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage*; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000188:drug therapy* / Q000401:mortality*
D000806:Angiotensin-Converting Enzyme Inhibitors