Cumulative evidence supports the use of angiotensin-converting enzyme (ACE) inhibitors for stable coronary artery disease in patients with and without heart failure. The dose and unique properties of ACE inhibitors, trial data, differences in trial design and demographics, may all contribute to variable responses in clinical outcomes. Pending direct comparator clinical trials between a tissue ACE inhibitor vs a plasma ACE inhibitor, evidence indicates that both ramipril and perindopril can be recommended for secondary risk prevention.
The SOLVD Investigators . Effect of enalapril on survival in patients with reduced left ventricular ejection fractions and congestive heart failure. N Engl J Med325:293-302, 1991
2.
Pfeffer MA , Brunwald E, Moyee LA, et al. Effect of captopril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. N Engl J Med327:685-691, 1992
3.
Pitt B , O’Neill B, Feldman R, et al; the QUIET Study Group. The Quinapril Ischemic Event Trial (QUIET): Evaluation of chronic ACE inhibitor therapy in patients with ischemic heart disease and preserved left ventricular function. Am J Cardiol87:1058-1063, 2001
4.
Yusuf S , Sleight P, Pogue J, et al; The Heart Outcomes Prevention Evaluation Study Investigators. Effects of an Angiotensis-Converting-Enzyme Inhibitor, Ramipril, on Cardiovascular Events in High-Risk Paitents. N Engl J Med342:145-153, 2000
5.
Fox KM ; The EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery Disease Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease (the EUROPA study). Lancet362:782-788, 2003
6.
Braunwald E , Domanski MJ, Fowler SE, et al; The PEACE Trial Investigators. Angiotensin-Converting-Enzyme Inhibition in Stable Coronary Artery Disease. N Engl J Med351(20):2058-2068, 2004
