Trandolapril Cardiac Evaluation (TRACE) study results

Canadian Medical Association Journal 1996; 154: 863

Source: Køber L, Torp-Pedersen C, Carlsen JE et al: A clinical trial of the angiotensin-converting-enzyme inhibitor trandolapril in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 1995; 333: 1670-1676

To determine whether patients who have left ventricular dysfunction soon after acute myocardial infarction (AMI) benefit from long-term angiotensin-converting-enzyme (ACE) inhibition, Danish researchers randomly assigned 1749 patients to receive trandolapril (1 to 4 mg/d) or a placebo, starting 3 to 7 days after AMI, for 2 to 4 years. The relative risk of death from any cause was significantly reduced in the treatment group, as was the risk of death from cardiovascular causes, of sudden death and of progression to severe heart failure. Cough and hypotension were the most frequent side effects of treatment. Because earlier trials involving smaller or unscreened patient groups did not find a significant benefit of ACE inhibition after AMI, the researchers argue that the presence of left ventricular dysfunction may help to identify patients likely to benefit from this therapy.

| CMAJ March 15, 1996 (vol 154, no 6) |