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Evidence summaries

Angiotensin-Receptor Blockers (Arb)and the Risk of Myocardial Infarction

Angiotensin-receptor blockers do not increase the risk of myocardial infarction compared with placebo or angiotensin-converting enzyme inhibitors. Level of evidence: "A"

A systematic review 1 including 19 studies with a total of 31,569 subjects was abstracted in DARE. ARBs did lead to a statistically nonsignificant decrease in the risk of MI when compared with placebo (OR 0.94, 95% CI: 0.75, 1.16), based on 11 trials (n=21,062). However statistically significant heterogeneity was noted. When compared with ACE inhibitors, the OR was 1.01 (95% CI: 0.87 to 1.16), based on 9 trials (n=10,625). The OPTIMAAL trial of losartan versus captopril in patients with recent MI or ischaemic syndrome accounted for 86.8% of the weighted OR.

Primary/Secondary Keywords