The Use of Angiotensin Converting Enzyme Inhibitors in Patients After Myocardial Infarction

Nowadays angiotensin-converting enzyme inhibitors (ACE-is) are considered to be a cornerstone in the treatment of congestive heart failure (CHF). These agents have been shown to improve survival and functional status of patients with CHF. It is logical to start therapy with ACE-is in the first hours or days of acute myocardial infarction (MI) to further improve survival and prevent CHIF after MI. The several randomized placebo-controlled trials were performed to assess the effects of early therapy with ACE-is on the outcomes of Mi. Mortality after MI was significantly reduced only in these trials in which therapy with ACE-is was introduced 3-16 days after MI in patients with clinical evidence of CHIF or left ventricular systolic dysfunction as well as in patients with noneffective thrombolysis (or without thrombolysis) or diabetes mellitus.