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Effect of very early angiotensin-converting enzyme inhibition on left ventricular dilation after myocardial infarction in patients receiving thrombolysis

Results of a meta-analysis of 845 patients

Pieter J. de Kam, MSc^*, Adriaan A. Voors, MD, PhD , Maarten P. van den Berg, MD, PhD^*, Dirk J. van Veldhuisen, MD, PhD, FACC^*, Jan Brouwer, MD, PhD^*, Harry J. G. M. Crijns, MD, PhD^*, Claudio Borghi, MD, Ettore Ambrosioni, MD, Judith S. Hochman, MD^||, Thierry H. LeJemtel, MD^¶, Jan-Herre Kingma, MD, PhD, Martin St. John Sutton, MD, MBBS, FACC^#, Wiek H. van Gilst, PhD^* on behalf of the FAMIS CAPTIN and CATS Investigators

^* Department of Cardiology, University Hospital, Groningen, The Netherlands
Department of Cardiology, St. Anthonius Hospital, Nieuwegein, The Netherlands
Department of Clinical Pharmacology, University of Groningen, Groningen, The Netherlands
Department of Cardiology, University of Bologna, Bologna, Italy
^|| Department of Cardiology, St. Luke’s–Roosevelt Hospital, New York, New York, USA
^¶ Division of Cardiology, Albert Einstein College of Medicine, New York, New York, USA
^# Cardiovascular Division, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA

View larger version (23K): [in a new window]   Figure 1 The effect of ACE inhibitor treatment within 6 to 9 h on LV dilation in patients receiving thrombolysis (n = 845) after MI. Data are presented as the mean value ± SEM.

View larger version (35K): [in a new window]   Figure 2 The effect of ACE inhibitor treatment within 6 to 9 h on LV dilation after MI in various subgroups. Data are presented as the mean value and 95% CI. BSA = body surface area; CPK = creatine phosphokinase; MAP = mean arterial pressure.

View larger version (21K): [in a new window]   Figure 3 The effect of ACE inhibitor treatment within 6 to 9 h on LV dilation for patients in whom reperfusion therapy failed (n = 212) after MI. Data are presented as the mean value ± SEM.

View larger version (23K): [in a new window]   Figure 4 The effect of successful reperfusion after thrombolysis on LV dilation for the placebo group (n = 421) after MI. Data are presented as the mean value ± SEM.