Angiotensin-converting enzyme inhibitors in coronary artery disease and preserved left ventricular systolic function

Angiotensin converting enzyme inhibitors (ACEI) have been shown to be beneficial in patients with hypertension, recent myocardial infarction (MI), patients undergoing percutaneous coronary intervention (PCI) and/or left ventricular (LV) dysfunction. However, the evidence for routine administration of ACEI has been conflicting in patients with coronary artery disease (CAD) with preserved LV systolic function.In this chapter, we will review the potential anti-atherosclerotic mechanisms of ACEI.In addition, we will summarize the randomized clinical trials supporting the potential benefitsof ACEI in patient with CAD and preserved LV function. The potential differences in the study design, patient population, individual ACEI pharmacokinetic and pharmacodynamic characteristics and therapeutic blood pressure differences between the trials will be addressed. In addition, we will also present an updated meta-analysis of the above trials.In summary, we believe that the current evidence supports that routine treatment with ACEIin patients with CAD who have preserved LV function.