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Angiotensin-Converting Enzyme Inhibitors (ACE) in Congestive Heart Failure

Osamu Fukuyama, MD
Arch Intern Med. 1991;151(8):1669-1670. doi:10.1001/archinte.1991.00400080149033.
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To the Editor —  Deedwania1 presented an excellent review on the use of ACE inhibitors in congestive heart failure, but I do not believe there is enough data to support his conclusion that "... a short-acting ACE inhibitor such as captopril may be preferred for the treatment of selected patients with CHF [congestive heart failure] to minimize these risks."Although he had mentioned the interim report of the multicenter lisinoprilcaptopril congestive heart failure study group,2 his article omitted their final report3 that showed that lisinopril was superior in improving ejection fraction, functional capacity, and quality of life and that it produced fewer serious adverse experiences compared with captopril.At present, the data are inconclusive regarding the superiority of one ACE inhibitor over other agents, and absolutely agree with Jessup's opinion that "... unfortunately, until more research is accomplished, the choice of an ACE inhibitor for the patient with heart


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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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