ACE Inhibitors after Myocardial Infarction

To the Editor: Dr. Pfeffer and the investigators of the Survival and Ventricular Enlargement (SAVE) study recently (Sept. 3 issue) 1 presented the results of a carefully designed clinical trial suggesting that long-term treatment with the angiotensin-converting-enzyme (ACE) inhibitor captopril can improve survival and reduce cardiovascular morbidity in asymptomatic patients with left ventricular dysfunction after myocardial infarction. However, the authors fail to address the striking discrepancy between women and men in the benefit of ACE inhibition. As shown in Table 3 of the article, the risk reduction for one of the major end points, death from all causes, was only 2 . . .