Summaries for Patients |

ACE Inhibitors after Heart Attacks: Varying Effects? FREE

[+] Article, Author, and Disclosure Information

The summary below is from the full report titled “Mortality Rates in Elderly Patients Who Take Different Angiotensin-Converting Enzyme Inhibitors after Acute Myocardial Infarction: A Class Effect?” It is in the 20 July 2004 issue of Annals of Internal Medicine (volume 141, pages 102-112). The authors are L. Pilote, M. Abrahamowicz, E. Rodrigues, M.J. Eisenberg, and E. Rahme.

Ann Intern Med. 2004;141(2):I-34. doi:10.7326/0003-4819-141-2-200407200-00003
Text Size: A A A

What is the problem and what is known about it so far?

Heart attacks occur when blood flow through the arteries to the heart is blocked for a long enough time to damage or kill a portion of heart muscle. Although some people with heart attacks die immediately, most survive. Doctors usually recommend that these survivors take several drugs. They often prescribe drugs called angiotensin-converting enzyme (ACE) inhibitors because several studies showed that these drugs helped prevent future heart attacks and death. However, there are many different ACE inhibitors, and some were not tested in the trials. Most doctors think that all ACE inhibitors have similar effects; however, some of these drugs might prevent future heart problems and death better than others.

Why did the researchers do this particular study?

To determine whether the risk of dying in the first year after a heart attack is similar among people taking different ACE inhibitors.

Who was studied?

7512 patients older than 65 years of age who received prescriptions for ACE inhibitors after a heart attack.

How was the study done?

The researchers used a database of discharge summaries from 109 hospitals in Quebec, Canada, to identify older patients who survived heart attacks between 1996 and 2000. They then used a claims database to identify the patients who filled prescriptions for an ACE inhibitor after leaving the hospital. They selected patients who refilled prescriptions for the same ACE inhibitor several times rather than patients who switched drugs. The researchers then compared death rates 1 year after the heart attack among patients taking different ACE inhibitors.

What did the researchers find?

Patients who filled prescriptions for ramipril had lower death rates within the first year of hospital discharge than did those who filled prescriptions for several other ACE inhibitors, including captopril, enalapril, fosinopril, and quinapril.

What were the limitations of the study?

The databases used by the researchers lacked detailed clinical information. Some doctors may have given sicker patients certain ACE inhibitors more frequently. The researchers addressed this possibility in their analyses, but they may not have accounted for all situations that could make the risk of death seem to be related to a particular ACE inhibitor.

What are the implications of the study?

Doctors and patients should not assume that all ACE inhibitors have similar effects on death rates after heart attacks.





Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.