What are the roles of ACE inhibitors, ARBs, and aldosterone blockers in the treatment of acute myocardial infarction (MI, heart attack)?

Updated: May 07, 2019
  • Author: A Maziar Zafari, MD, PhD, FACC, FAHA; Chief Editor: Eric H Yang, MD  more...
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Answer

Initiate angiotensin-converting enzyme (ACE) inhibitors and continue administration indefinitely in all patients with a left ventricular ejection fraction that is less than 40% and in those with hypertension, diabetes mellitus, or stable chronic kidney disease, unless contraindicated. [111, 112]

Angiotensin-receptor blockers (ARBs) are recommended in patients who are intolerant of ACE inhibitors. [113]

Aldosterone blockers are recommended in addition to beta blockers and ACE inhibitors in patient who have had an MI with a reduced left ventricular ejection fraction of less than 40%, provided they have no renal impairment and have normal blood potassium levels (114</ref>


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