A systematic review 1 including 6 studies with a total of 33 500 subjects was abstracted in DARE. Studies examining the benefits of angiotensin-converting enzyme inhibitors (ACEIs) in patients with coronary artery disease and preserved left ventricular systolic function (ejection fraction of at least 40% and/or the absence of congestive heart failure) were included. The included studies assessed ramipril, perindopril, trandolapril, quinapril and enalapril, and the mean follow-up ranged from 2 to 4.8 years. Compared with placebo, ACEI treatment was associated with a decrease in cardiovascular mortality (RR 0.83, 95% CI 0.72 to 0.96), nonfatal myocardial infarction (RR 0.84, 95% CI 0.75 to 0.94), all-cause mortality (RR 0.87, 95% CI 0.81 to 0.94), and revascularization rates (RR 0.93, 95% CI 0.87 to 1.00). Treatment of 100 patients for an average duration of 4.4 years prevents either of the adverse outcomes (one death, or one nonfatal myocardial infarction, or one cardiovascular death or one coronary revascularization procedure).
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