Is Angiotensin converting enzyme inhibitor useful for secondary prevention after acute myocardial infarction? An interim report of Japanese Angina and Myocardial infarction Prospective (JAMP) study

• Published in: Journal of the Japanese Association for Cerebro-cardiovascular Disease Control Vol. 35; no. 1; pp. 8 - 16
• Main Author: Group, JAMP Study
• Format: Journal Article
• Language: Japanese
• Published: The Japanese Association for Cerebro-cardiovascular Disease Control 31.01.2000; 社団法人 日本循環器管理研究協議会
• Subjects: acute myocardial infarction; angiotensin converting enzyme inhibitor; long-term prognosis; randomized controlled trial; アンギオテンシン変換酵素阻害薬; 二次予防; 心筋梗塞症; 無作為比較対照試験
• ISSN: 0914-7284
• DOI: 10.11381/jjcdp1974.35.8

To investigate if angiotensin converting enzyme inhibitor (ACEI) is useful for secondary prevention after acute myocardial infarction, a randomized controlled trial was carried out in 43 institutions in of Japan from September 1993. A total of 1, 025 survivors of their first acute myocardial infarction who underwent coronary angiographies, consisting of 799 men and 226 women, were included. Mean age was 62.4±10.7 years. Subjects were randomly assigned to 2 groups, 501 who received ACEI (ACEI group) and 524 who received no ACEI (non-ACEI group). There were no statistical differences in the clinical backgrounds, except that smokers were more frequent and patients who underwent percutaneous transluminal coronary angioplasty before discharge were less frequent in the ACEI group. The primary end points were cardiac events, which were defined as sudden death ; fatal or nonfatal recurrent myocardial infarction ; hospitalization because of worsening angina or congestive heart failure ; and coronary revascularization. During the provisional mean follow-up period of 42 months, cardiac events occurred in 105 patients of the ACEI group and 125 of the non-ACEI group. With Kaplan-Meier's analysis, the rate of total cardiac events was 30.1% in the ACEI group and 26.5% in the non-ACEI group. There was no statistical significance between the 2 groups with a log-rank test. The final patient was recruited in December 1995, and it is planned that longterm observation will terminate by the end of 2000.