Interaction Between Enalapril and Aspirin on Mortality After Acute Myocardial Infarction: Subgroup Analysis of the Cooperative New Scandinavian Enalapril Survival Study II (CONSENSUS II)
Section snippets
Methods
The CONSENSUS II trial included 6,090 patients with AMI, who were assigned to treatment with enalapril or placebo in a randomized, double-blind, placebo-controlled parallel-group design. The primary end point was death due to any cause that occurred within 6 months. Secondary end points included death ≤1 month, the cause of death, reinfarction, and worsening CHF as indicated by a change in treatment or hospitalization due to CHF. Details of the study design and results were previously presented.
Results
The use of ASA at baseline was equally represented in the enalapril (76.5%) and placebo (77.8%) groups. The difference between the ASA and non-ASA group is slight, but statistically significant (p <0.05), regarding several baseline characteristics (Table 1). The effect of enalapril on mortality and all major events was previously described.[2]Overall, enalapril increased relative risk of deaths by 10%, though not significantly. Fig. 1 shows the unadjusted odds ratios and their 95% confidence
Aspirin
ASA use at baseline was associated with lower mortality and rates of all nonfatal major events. The odds reduction in mortality found in this study (odds ratio 0.41) was far larger than the odds reduction of about 25% observed in previous studies.[1]The reason for this difference may be that the ASA group at baseline seemed to be slightly healthier: lower age, less frequent previous AMI, CHF, diabetes, and angina, and more frequent use of thrombolytics (Table 1). The main purpose of this study,
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