Angiotensin-converting Enzyme Inhibitors Decrease the Risk of Cardiac Rupture after Acute Myocardial Infarction: A Meta-analysis of Randomized Controlled Trials

Background: ACEI therapy decreases mortality in patients with acute MI. However, the effects of ACEIs on CR are unclear. Methods: A comprehensive search of PUBMED, EMBASE, ISI Web of Science, MEDLINE and the Cochrane Register of Controlled Trials before July 2022 was conducted to identify all RCTs on ACEIs that recorded CR as an outcome. Review Manager 5.3 was used to analyze the data. Results: Five RCTs including 26,383 patients with MI were identified; 71 of the 13,159 patients receiving ACEIs and 107 of the 13,224 control patients were verified to have CR. ACEI therapy started within 24 hours after the onset of acute MI significantly decreased the risk of CR, by 33% (RR: 0.67, 95% CI: 0.50-0.90, P= 0.008). Conclusions: Early administration of ACEIs (within 24 hours after the onset of acute MI) decreased the incidence of CR in patients with acute MI.