In this meta-analysis, add-on ACE-Is lowered morbidity and mortality.
Angiotensin-converting–enzyme inhibitors (ACE-Is) and angiotensin II–receptor blockers (ARBs) benefit patients with depressed ejection fractions after myocardial infarction. In a systematic review, researchers identified nine randomized trials, two nonrandomized controlled studies, and six systematic reviews (>30,000 total participants) that addressed the effects of ACE-Is and ARBs when added to standard therapy (e.g., antiplatelet and lipid-lowering therapies) for patients with ischemic heart disease and preserved left ventricular function.
Compared with placebo, ACE-Is were associated with lower cardiovascular mortality (in 6 trials) and total mortality (in 7 trials); fewer nonfatal MIs (in 6 trials) and strokes (in 7 trials); and fewer di…