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European Heart Journal 1994 15(Supplement B):9-13; doi:10.1093/eurheartj/15.suppl_B.9
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Role of Angiotensin Converting Enzyme Inhibitors in Patients with Left Ventricular Dysfunction and Congestive Heart Failure

R. McKelvie{dagger}, D. McConachie{ddagger} and S. Yusuf*,

{dagger} Career Scientist of the Ministry of Health of Ontario
{ddagger} Research Fellow of the Ontario Heart and Stroke Foundation
* Division of Cardiology and the Preventive Cardiology and Therapeutics Program, Hamilton General Hospital, McMaster University Hamilton, Ontario, Canada

Correspondence: Dr Salim Yusuf. Director, Division of Cardiology, HGH-McMaster Clinic, 237 Barton Street East, Hamilton, Ontario, Canada L8L 2X2.

We now have conclusive data that ACE inhibitors reduce mortality, morbidity, and symptoms in patients with low ejection fraction and/or heart failure. Therefore, ACE inhibitors should be routinely used in all such patients, as long as there are no clear contraindications. Routine use of ACE inhibitors will lead to prolongation of survival and a reduction in the number of hospitalizations for heart failure and ischaemic events. The reduction in costs associated with the prevention of these events is likely substantially to offset the cost of the use of these therapies. Therefore, ACE inhibitors should be instituted as early as possible in patients with LV dysfunction.

Key Words: Converting enzyme inhibitor • heart failure • mortality • morbidity • heart failure trials


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