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- W2014367132 abstract "Alistair Hall and colleagues1Hall AS Murray GD Ball S on behalf of the AIREX Study investigatorsFollow-up study of patients randomly allocated ramipril or placebo for heart failure after acute myocardial infarction: AIRE Extension (AIREX) Study.Lancet. 1997; 349: 1493-1497Summary Full Text Full Text PDF PubMed Scopus (180) Google Scholar report the long-term survival benefits of ramipril in heart failure after acute myocardial infarction, but the data presented do not fully support their conclusions. First, this study makes claims for the enhanced survival of patients on ramipril, but there are no data on morbidity or cause of death in either group. Although this was not a stated aim of the study, the absence of evidence on the potential adverse effects of ramipril weakens the argument that long-term angiotensin-converting-enzyme (ACE)-inhibitor therapy should be the norm. Since the survival benefit of ramipril is thought to relate to its cardioprotective properties, information about the relative rates of death from cardiovascular and other causes should have been examined. Second, the investigators conclude that indefinite therapy with ACE inhibitors should be given unless tolerance develops. Although these data show that long-term survival was enhanced in patients in the treatment arm of the original trial, the therapy received by patients beyond the 12 months of the trial period is unknown in both groups of patients. The advantage or disadvantage of therapy beyond 12 months is not addressed. It is therefore inappropriate to suggest indefinite therapy from these data. Finally, in their conclusion, Hall and colleagues state that the effects of ramipril are more pronounced in patients older than 65 years and those treated with diuretics at the time of randomisation. This claim is not referenced or supported by the data presented. The data do show that the apparent survival benefits of ramipril in heart failure after acute myocardial infarction are maintained in the long term. However, since the study addresses neither the question of morbidity nor the optimum duration of therapy, the investigators' claims that indefinite treatment with ACE inhibitors should be routine are not substantiated. AIRE Extension (AIREX) StudyAuthors' reply Full-Text PDF" @default.
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- W2014367132 date "1997-08-01" @default.
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- W2014367132 title "AIRE Extension (AIREX) Study" @default.
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- W2014367132 doi "https://doi.org/10.1016/s0140-6736(05)63424-1" @default.
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