Early treatment with ACE inhibitors in acute myocardial infarction

ACE inhibitors administered within 24 hours of symptom onset and continued for 10 days significantly reduce day 10 all-cause mortality (2 to 4 deaths prevented per 1000) in acute myocardial infarction.

A Cochrane review on effect of early treatment with ACE inhibitors (12 studies, n=84 456), beta-blockers (20), calcium channel blockers (CCBs) (18) and nitrates (18) on short and long-term mortality in patients with an acute cardiovascular event included 65 studies with a total of 166 206 subjects. Immediate ACE inhibitor treatment (started within 24 hours of the onset and lasting for maximum 2 days) was associated with a statistically non-significant reduction in all-cause mortality at 2 days (RR 0.91, 95% CI 0.82 to 1.00; 3 studies, n=77 414) and at 10 days (RR 0.68, 95% CI 0.12 to 3.98; 2 studies, n=145) in acute myocardial infarction. Short-term treatment (started within 24 hours of the onset and lasting for a maximum of 10 days) with ACE inhibitor was associated with a statistically significant reduction in all cause mortality at 10 days as compared to placebo (RR 0.93, 95% CI 0.87 to 0.98; 10 studies, n=84 311). No trial reported mortality at ≥ 30 days .

Ədəbiyyat

1. Perez MI, Musini VM, Wright JM. Effect of early treatment with anti-hypertensive drugs on short and long-term mortality in patients with an acute cardiovascular event. Cochrane Database Syst Rev 2009;(4):CD006743.