Effects of long-term treatment with angiotensin-converting-enzyme inhibitors in the presence or absence of aspirin: A systematic review

Koon K. Teo, Salim Yusuf, Marc Pfeffer, Lars Kober, Alistair Hall, Janice Pogue, Roberto Latini, Rory Collins

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Background: Results from a retrospective analysis of the Studies of Left Ventricular Dysfunction (SOLVD) study suggest that angiotensin-converting-enzyme (ACE) inhibitors may be less effective in patients receiving aspirin. We aimed to confirm or refute this theory. Methods: We used the Peto-Yusuf method to undertake a systematic overview of data for 22 060 patients from six long-term randomised trials of ACE inhibitors to assess whether aspirin altered the effects of ACE inhibitor therapy on major clinical outcomes (composite of death, myocardial infarction, stroke, hospital admission for congestive heart failure, or revascularisation). Findings: Baseline characteristics, and prognosis in patients allocated placebo, differed strikingly between those who were and were not taking aspirin at baseline. Results from analyses of all trials, except SOLVD, did not suggest any significant differences between the proportional reductions in risk with ACE inhibitor therapy in the presence or absence of aspirin for the major clinical outcomes (p=0.15), or in any of its individual components, except myocardial infarction (interaction p=0.01). Overall, ACE inhibitor therapy significantly reduced the risk of the major clinical outcomes by 22% (p

Original languageEnglish
Pages (from-to)1037-1043
Number of pages7
Issue number9339
Publication statusPublished - Oct 5 2002


ASJC Scopus subject areas

  • Medicine(all)

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