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

The aim of the present study was to evaluate the possible interaction betwe en chronic aspirin therapy and angiotensin-converting enzyme inhibitor (ACE -I) on left ventricular ejection fraction (LVEF) in patients surviving an a cute myocardial infarction (AMI). Forty-two patients with reduced LVEF were recruited from the warfarin aspirin reinfarction study (WARIS-II), a rando mized, open study comparing enteric coated aspirin (160 mg/d), warfarin (IN R 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 bioc hemical measurements were performed before discharge and after 3 months. Th e 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 r egarding the main end point, LVEF. Furthermore, neither endothelin-1 nor AN P showed significant differences between the treatment groups. A possible i nteraction between ACE-I and aspirin might theoretically lead to reduced le vels of renin activity in patients on aspirin, but we did nor find anp such inter-group difference. In conclusion, we did not find evidence of interac tion between ACE-I and low-dose aspirin. (C) 2001 European Society of Cardi ology. All rights reserved.