Long-term survival benefit of ramipril in patients with acute myocardial infarction complicated by heart failure

The long-term survival benefits of ACE inhibition in the study population of the Acute Infarction Ramipril Efficacy (AIRE) study has been investigated (1)

• in the original study the duration of masked trial therapy in the UK cohort (603 patients, mean age=64.7 years, 455 male patients) was 12.4 and 13.4 months for ramipril (n=302) and placebo (n=301), respectively
• extension of life between ramipril and placebo groups was 14.5 months (95% CI 13.2 to 15.8)
  • ramipril increased life expectancy more for patients with than without diabetes (life expectancy difference 32.1 vs 5.0 months), previous acute myocardial infarction (AMI) (20.1 vs 4.9 months), previous heart failure (19.5 vs 4.9 months), hypertension (16.6 vs 8.3 months), angina (16.2 vs 5.0 months) and age >65 years (11.3 vs 5.7 months)
  • the study authors concluded that for patients with clinically defined heart failure following acute myocardial infarction, ramipril results in a sustained survival benefit, and is associated with an extension of life of up to 14.5 months for, on average, 13 months treatment duration

Reference:

• Wu J et al Long-term survival benefit of ramipril in patients with acute myocardial infarction complicated by heart failure.Heart Published Online First: 15 January 2021. doi: 10.1136/heartjnl-2020-316823