Laboratoire Cardioprotection, Remodelage et Thrombose, University of Angers, L'UNAM University and Cardiology Department, University Hospital of Angers, Angers (S.G., L.B., M.L.N., W.A.-K., S.D., F.P., A.F.); Cardiology Department, Hospital of Cholet, Cholet (J.-M.B.); Cardiology Department, Haut-Anjou Hospital, Chateau-Gontier (P.L.-C); and Cardiology Department, Hospital of Saumur, Saumur (C.R.), France

摘要

Several studies have proven the beneficial effects of Beta-blockers (BB) and angiotensin-converting enzyme inhibitors (ACEI) in reducing major adverse cardiac events (MACE) and mortality following myocardial infarction (MI).~1-5 Particular benefits were observed among patients with high-risk features, such as heart failure during hospitalization or left ventricular ejection fraction (LVEF) <40%.6-8 Most of these studies took place before modern medicine's reperfusion era, and European Society of Cardiology guidelines advocate BB following MI with a class lib recommendation and ACEI with a class Ha recommendation. In patients with LV dysfunction, the level of recommendation is class la for both drug groups.9 A recent, nationwide, French study reported improved prescription rates of BB and ACEI following ST-elevation MI in the years 2008-2010, yet did not provide any detail regarding the doses given.10 Some registries noted that BB and ACEI were used at lower doses than in clinical trials.11 In contrast to