PMID- 16054435
OWN - NLM
STAT- MEDLINE
DCOM- 20060418
LR  - 20110608
IS  - 1388-9842 (Print)
IS  - 1388-9842 (Linking)
VI  - 8
IP  - 1
DP  - 2006 Jan
TI  - Effect of angiotensin-converting enzyme inhibition on functional class in 
      patients with left ventricular systolic dysfunction--a meta-analysis.
PG  - 90-6
AB  - BACKGROUND: The effect of angiotensin converting enzyme (ACE) inhibitors on 
      symptoms in patients with left ventricular systolic dysfunction (LVSD) is 
      controversial. AIMS: To perform a meta-analysis of studies evaluating effect of 
      ACE inhibitors on New York Heart Association (NYHA) class in patients with LVSD. 
      METHODS: Individual data from 10389 patients in NYHA classes I-IV from four large 
      long-term studies (2-4-year follow-up) and summary data from 2302 patients in 
      NYHA classes II-IV from 16 short-term studies (3 months follow-up) were 
      meta-analysed to assess changes in NYHA class. RESULTS: The large long-term 
      studies showed a significant improvement in the worst NYHA classes (classes II-IV 
      compared to class I) in the ACE inhibitor arm versus placebo, odds ratio (OR) = 
      0.875 (0.811-0.943) p = 0.0005. This effect was only present in studies which 
      included patients with chronic heart failure and was particularly pronounced on 
      deterioration to the worst NYHA class IV, OR = 0.66 (0.52-0.84) p = 0.001. There 
      was no effect in the studies which included patients after myocardial infarction. 
      The short-term chronic heart failure studies showed a significant improvement in 
      NYHA class; OR for improvement of at least one NYHA class was 2.11 (1.48-2.98, 
      95% CI) p < 0.0001. CONCLUSION: ACE inhibition significantly improves symptomatic 
      status measured as NYHA classification in patients with chronic heart failure.
FAU - Abdulla, Jawdat
AU  - Abdulla J
AD  - Department of Cardiology P, Gentofte University Hospital, Copenhagen, Denmark. 
      ja@heart.dk
FAU - Pogue, Janice
AU  - Pogue J
FAU - Abildstrom, Steen Z
AU  - Abildstrom SZ
FAU - Kober, Lars
AU  - Kober L
FAU - Christensen, Erik
AU  - Christensen E
FAU - Pfeffer, Marc A
AU  - Pfeffer MA
FAU - Yusuf, Salim
AU  - Yusuf S
FAU - Torp-Pedersen, Christian
AU  - Torp-Pedersen C
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
DEP - 20050727
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
RN  - 0 (Angiotensin-Converting Enzyme Inhibitors)
SB  - IM
CIN - Evid Based Cardiovasc Med. 2006 Jun;10(2):106-7. PMID: 16753512
MH  - Angiotensin-Converting Enzyme Inhibitors/*therapeutic use
MH  - Follow-Up Studies
MH  - Heart Failure/drug therapy/etiology/physiopathology
MH  - Humans
MH  - Myocardial Contraction/*drug effects/physiology
MH  - Randomized Controlled Trials as Topic
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/complications/*drug therapy/physiopathology
EDAT- 2005/08/02 09:00
MHDA- 2006/04/19 09:00
CRDT- 2005/08/02 09:00
PHST- 2004/09/23 00:00 [received]
PHST- 2005/03/03 00:00 [accepted]
PHST- 2005/08/02 09:00 [pubmed]
PHST- 2006/04/19 09:00 [medline]
PHST- 2005/08/02 09:00 [entrez]
AID - S1388-9842(05)00078-4 [pii]
AID - 10.1016/j.ejheart.2005.03.006 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2006 Jan;8(1):90-6. doi: 10.1016/j.ejheart.2005.03.006. Epub 
      2005 Jul 27.