ORAL CAPTOPRIL VERSUS PLACEBO AMONG 13634 PATIENTS WITH SUSPECTED ACUTE MYOCARDIAL-INFARCTION - INTERIM-REPORT FROM THE CHINESE CARDIAC STUDY (CCS-1)

13 634 patients entering 650 Chinese hospitals up to 36 h after the on set of suspected acute myocardial infarction (MI) were randomised betw een one month of oral captopril (6.25 mg initial dose, 12.5 mg 2 h lat er, and then 12.5 mg three times daily) or matching placebo. Captopril was associated with a non-significant reduction in 4-week mortality ( 617 [9.05%] captopril-allocated vs 654 [9.59%] placebo-allocated death s; 2p=0.3). There was a significant excess of hypotension, mostly earl y after the start of treatment, but no evidence of any adverse effect on early mortality (even among patients who were hypotensive at entry) . Taken together with the other trials of converting enzyme inhibitors started early in acute MI, these results indicate that such therapy i s generally safe and typically prevents about 5 deaths per 1000 patien ts treated for the first month.