Results of a meta-analysis suggest that the current guideline recommendation for their use in most cases may need to be revisited.
Based on early studies, current guidelines recommend renin angiotensin system (RAS) inhibitors for all patients with stable ischemic heart disease and any one of the following conditions: hypertension, diabetes, left ventricular ejection fraction (LVEF) ≤40%, or chronic kidney disease. To evaluate the impact of more-recent studies on the evidence base, researchers conducted a meta-analysis of randomized trials comparing RAS inhibitors with placebo or active controls in patients with stable coronary artery disease (CAD) without heart failure. Included were 24 trials involving 61,961 patients; average follow-up was 3.2 years. Eighteen trials were placebo-controlled, and seven had active controls (calcium-channel antagonists in 4, thiazide diu…
Reviewing Author
DisclosuresGrant/Research SupportNIH–National Heart, Lung, and Blood Institute
DisclosuresGrant/Research SupportNIH–National Heart, Lung, and Blood Institute