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European Journal of Heart Failure 2001 3(2):203-207; doi:10.1016/S1388-9842(00)00138-0
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© 2001 European Society of Cardiology

Aspirin does not influence the effect of angiotensin-converting enzyme inhibition on left ventricular ejection fraction 3 months after acute myocardial infarction

Mette Hurlena,*, Torstein Holeb, Ingebjørg Seljeflotc and Harald Arnesena

a Department of Cardiology, Ullevål University Hospital Oslo, Norway
b Medical Department, Central Hospital of Møre and Romsdal Oslo, Norway
c Research Forum, Ullevål University Hospital Oslo, Norway

* Corresponding author. Tel: +47-22-11-80-80; fax: +47-22-11-79-65.


  Abstract

The aim of the present study was to evaluate the possible interaction between chronic aspirin therapy and angiotensin-converting enzyme inhibitor (ACE-I) on left ventricular ejection fraction (LVEF) in patients surviving an acute myocardial infarction (AMI). Forty-two patients with reduced LVEF were recruited from the warfarin aspirin reinfarction study (WARIS-II), a randomized, open study comparing enteric coated aspirin (160 mg/d), warfarin (INR 2.8–4.2) and the combination of aspirin (75 mg/d) and warfarin (INR 2.0–2.5) on mortality, reinfarction and stroke after AMI. LVEF and relevant biochemical measurements were performed before discharge and after 3 months. The overall LVEF increased during the study period from median 35 to 39% (P < 0.001). There was no difference between patients on aspirin and warfarin regarding the main end point, LVEF. Furthermore, neither endothelin-1 nor ANP showed significant differences between the treatment groups. A possible interaction between ACE-I and aspirin might theoretically lead to reduced levels of renin activity in patients on aspirin, but we did not find any such inter-group difference. In conclusion, we did not find evidence of interaction between ACE-I and low-dose aspirin.

Key Words: Angiotensin-converting enzyme inhibitor • Aspirin • Myocardial infarction • Interaction • Left ventricular ejection fraction

Received April 10, 2000; Revised August 11, 2000; Accepted October 12, 2000


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