Several large trials (SAVE, AIRE, SMILE, TRACE, GISSi-lll and IS1S-IV) have shown both short- and long-term improvement in survival with ACE inhibitor therapy. The benefits are greatest in patients with low ejection fractions, large iufa, ction~ tn ulinical evidence of heart failure.
• The AIRE (Acute Infarction Ramipril Efficacy) and the AIREX (AIRE Extension) trials assessed the long-term (mean follow-up 59 months) efficacy of ramipril compared with placebo in 603 patients with heart failure after myo-cardial infarction. Treatment with ramipril resulted in a large and sustained reduction in mortality (relative risk reduction 36%).
• The SAVE (Survival and Ventricular Enlargement) Trial compared the effect of captopril or placebo in 2231 patients up to 16 days post myocardial infarction with an asymptomatic ejection fraction ?