BRIEF ANALYSIS - EFFICACY OF TREATMENT FO R CAPTOPRIL AFTER MYOCARDIAL-INFARCTION

The recently published << Survival and Ventricular Enlargement >> (SAV E), prospective controlled trial over 4 years including over 2 000 pat ients, has shown that long-term treatment with captopril reduced cardi ovascular mortality (- 19 %) and morbidity in patients with post-infar ction left ventricular dysfunction without signs of cardiac failure. B ased on the trial data, the extra cost of treating the patients with c aptopril compared with the placebo branch is estimated at 9.3 million french francs. This expense is compensated by a reduction in the cost of hospitalisation for cardiac failure of 1.6 million francs and a red uction in the cost of further coronary events of 3.4 million francs. A bove all, the extra cost is compensated by a gain of 47 deaths avoided , corresponding to about 493.5 years of life saved. The cost-effective ness of captopril administration is therefore about 8.750 francs per y ear per life saved. The ratio is significantly less than that of other primary or secondary prevention therapeutic strategies. On this basis , we conclude that captopril therapy of high risk post-infarction pati ents is a solution that is not only medically effective but also econo mically sound.