Effect of the ACE inhibitor lisinopril on mortality in diabetic patients with acute myocardial infarction: Data from the GISSI-3 study

Giulio Zuanetti, Roberto Latini, Aldo P. Maggioni, MariaGrazia Franzosi, Luigi Santoro, Gianni Tognoni

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Mortality of diabetic patients with acute myocardial infarction (MI) remains high despite recent improvement in their management. There is a need to evaluate efficacy and safety of novel treatments of MI in this high-risk population. We evaluated whether treatment with an ACE inhibitor begun within 24 hours from the onset of symptoms is able to decrease mortality and morbidity of diabetic patients with acute MI. Methods and Results: A retrospective analysis of the data of the GISSI-3 study in patients with and without a history of diabetes was performed. Patients with suspected acute MI were randomized to treatment with lisinopril (2.5 to 5 up to 10 mg/d) with or without nitroglycerin (5 to 20 μg IV then 10 mg/d) begun within 24 hours and continued for 6 weeks. The main end point was mortality at 6 weeks, and the secondary end point was a combined evaluation of mortality and severe left ventricular dysfunction. Information on diabetic status was available for 18 131 patients (≃94% of the total population enrolled), of whom 2790 patients had a history of diabetes. Treatment with lisinopril was associated with a decreased 6-week mortality in diabetic patients (8.7% versus 12.4%; OR, 0.68; 95% CI, 0.53 to 0.86; 37±12 lives saved per 1000 treated patients), an effect that was significantly (P

Original languageEnglish
Pages (from-to)4239-4245
Number of pages7
JournalCirculation
Volume96
Issue number12
Publication statusPublished - 1997

Keywords

  • Diabetes mellitus
  • Lisinopril
  • Mortality
  • Myocardial infarction

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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