Life expectancy in patients with myocardial infarction and heart failure through the lens of prescribing ramipril: brief overview of the evidence dossier

February 14, 2023
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Survival after an acute myocardial infarction (AMI) remains one of the basic indicators of the effectiveness of the treatment of this pathology. Despite the success of urgent treatment and secondary prevention of AMI, a significant number of patients develop chronic heart failure (HF), the course of which is associated with increased morbidity, mortality, and increased economic burden. Drug therapy, which is based on the use of four different groups of drugs, among which the main role is assigned to angiotensin-converting enzyme inhibitors and angiotensin-neprilysin receptor inhibitors, is recognized as an effective strategy for the management of such patients. The article examines in detail the results of the AIRE-S and PARADISE-MI studies, which analyzed the ability of ramipril to influence the life expectancy of patients with AMI and HF compared with placebo (AIRE-S) and sacubitril/valsartan (PARADISE-MI). As part of AIRE-S, the life expectancy of the specified cohort of patients has been proven to increase by an average of 13 months, with the maximum positive effect on the life expectancy of patients with concomitant diabetes, hypertension, and coronary heart disease. The PARADISE-MI study demonstrated that ramipril was not inferior to sacubitril/valsartan in the ability to protect patients with AMI, HF from cardiovascular death, occurrence and progression of HF (11.9% vs 13.2%, respectively; hazard ratio 0.90; 95% confidence interval 0.78–1.04; p=0.17).


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