A Role for ACE Inhibitors in MI Patients with Renal Insufficiency and LV Dysfunction

Chronic renal disease is associated with increased mortality risk in patients with LV dysfunction. To assess the risk associated with mild to moderate renal insufficiency, . . .

Chronic renal disease is associated with increased mortality risk in patients with LV dysfunction. To assess the risk associated with mild to moderate renal insufficiency, researchers retrospectively analyzed data from the SAVE trial, in which 2183 acute-MI patients with asymptomatic LV dysfunction (LV ejection fraction, ≤40%) and serum creatinine <2.5 mg/dL had been randomized to receive the ACE inhibitor captopril or placebo. Mean follow-up was about 3.5 years.

Patients were stratified by estimated glomerular filtration rate (GFR; measured in mL/minute/1.73 m²), calculated using a standard formula involving serum creatinine, age, race, and sex. After adjustment for potential confounders (including older age and more comorbidities among pat…

Reviewing Author

William T. Abraham, MD