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| Slide Lecture Programs |
| 2000 Core Curriculum |
| The endothelium: New insights into the origins and treatment of CAD |
August 31, 2000
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Heart failure: Role of ACE inhibition
- The benefits of ACE inhibition in patients with heart failure have been demonstrated in a number of large clinical trials including CONSENSUS, SOLVD, SAVE, and others conducted over more than a decade.66-68
- A meta-analysis of 32 trials of ACE inhibition in patients with symptomatic heart failure (NYHA functional class II or III) demonstrated a significant 23% reduction in total mortality and a 35% reduction in mortality or hospitalization for heart failure.69
- There were also trends toward fewer myocardial infarctions, strokes, and pulmonary emboli. Patients with the lowest ejection fractions had the greatest reduction in deaths and hospitalizations for heart failure.
- The trials involved several different ACE inhibitors and the results showed that they each produced similar benefits. Effects were consistent across various subgroups based on age, gender, heart failure etiology, and NYHA functional class.
- ACE inhibition reduces total mortality, heart failure mortality, hospitalization rates, progression of left ventricular dysfunction, and symptom severity, and increases exercise tolerance. The use of ACE inhibition benefits patients with symptomatic heart failure,66 asymptomatic left ventricular dysfunction,67 or those who are at risk for developing heart failure following myocardial infarction.68
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