Problem Acute MI + LV dysfunction
Format Multicenter, double-blinded, parallel-group, randomized, placebo-controlled trial
Treatment Captopril
Control Placebo
Population 2,231 patients
Inclusion criteria Age 21 years or older
MI within prior 3 days
New onset LVEF <40%
No overt LVF
Exclusion criteria Age >80
Contraindication to ACE inhibitors
Symptomatic CHF or HTN requiring ACEi
Serum creatinine level >2.5mg/dl
Other conditions believed to limit survival
Unstable course after infarction
Follow-up Mean 42 months
Primary endpoint All-cause mortality
Secondary endpoint(s) CHF requiring hospitalization or recurrent MI
CHF hospitalization
CHF requiring ACEi
Recurrent MI
CV death, CHF requiring ACE inhibitor, CHF hospitalization, or recurrent MI
Details -
Brief summary:
PAPER: Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. SAVE
Date 3 Sep 1992
Journal N Engl J Med. 1992 Sep 3;327(10):669-77.
Information Captopril in AMI with EF<40% but no overt CCF
-19% reduction in mortality
-Independent of age, EF%, prior MI, sex, BP, thrombolytic use, aspirin & beta-blockers (p=0.013)

See GISSI-3 for blanket ACEi use post-MI (regardless of EF)