Relationship between age and effect of early and long-term captopril treatment in patients with acute myocardial infarction

Objective To analyse the relationship between age and treatment with captop ril after acute myocardial infarction (AMI). Methods In a randomized trial, 822 patients with a first AMI received conve ntional medical treatment, including intravenous thrombolytic therapy and o ral aspirin or metoprolol, and then were randomly allocated to captopril [d osage from the first 6.25 mg to 25 mg/t.i.d, 209 younger patients (less tha n or equal to 64 years), 269 elderly patients (65 - 75 years)] or conventio nal treatment only (131 younger patients, 213 elderly). Survival in the fou r groups was calculated with the Kaplan-Meier method. Multivariate analysis was performed to understand the degree that multi-variables (including age ) affect survival in patients taking captopril in the hospital or during lo ng term follow-up. Results The survival of patients who took captopril correlated significantl y with age (P < 0.001). The survival of the elderly patients on captopril t reatment did increase ( P < 0.0001), but not of the younger ones ( P > 0.05 ) during hospitalization. During follow-up, the survival of patients who to ok captopril correlated insignificantly with age ( P > 0.05), but both the elderly and the younger patients have good survival rates (all P < 0.01) an d lower cardiac events (all P < 0.01) when they took captopril. Conclusions Captopril exerts a weak effect on the younger patients but a be neficial effect on the elderly patients during hospitalization after AMI. H owever, there is no difference between the younger and the elderly in the p rognosis, both having good survival and lower cardiac events when they take captopril long term during follow-up.