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ACE-Inhibitors Improve Outcomes in Coronary Artery Disease: Presented at AHA

By Jill Stein

DALLAS, TX -- November 15, 2005 -- Data from a large meta-analysis support a beneficial effect of treatment with angiotensin-converting-enzyme (ACE)-inhibitors added to conventional therapy on outcome in patients with coronary artery disease (CAD) and preserved left ventricular (LV) systolic function.

The findings were presented here on November 14^th at the American Heart Association's Scientific Sessions 2005 (AHA).

Mouaz Al-Mallah, MD, Chief Cardiology Fellow, Henry Ford Hospital, Detroit, Michigan, United States, and associates reviewed data in 33,959 patients with stable CAD and preserved LV systolic function who had been randomized to ACE-inhibitor treatment or placebo.

Participants were drawn from seven randomized, placebo-controlled trials. A total of 17,000 received an ACE inhibitor and 16,959 received placebo.

"The evidence for routine administration of ACE-inhibitors has been contradictory in patients with coronary artery disease with preserved LV systolic function," Dr. Al-Mallah observed. "While two large trials demonstrated a decrease in cardiovascular death and myocardial infarction, no such benefit was found in another large trial and in a few smaller trials."

The present investigation showed that ACE-inhibitor treatment produced a 3.9 mm Hg mean decrease in systolic blood pressure and a 1.8 mm Hg mean decrease in diastolic pressure.

ACE-inhibitor treatment was also associated with a reduction in cardiovascular mortality (RR=0.83, P = .006), non-fatal MI (RR=0.82, P = .001), all-cause mortality (RR=0.87, P = .0002), and revascularization (RR=0.92, P = .04).

"Our systematic review has several strengths," Dr. Al-Mallah noted. "For example, it helps answer the general question of the beneficial effects of ACE-inhibition in patients with coronary artery disease and preserved LV function with different treatment regimens," he said.


[Presentation title: Angiotensin-Converting-Enzyme Inhibitors Improve Outcomes in Patients with Coronary Artery Disease: a Meta-Analysis of Randomized Controlled Trials. Abstract 2153]

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