Effect of beta blockers alone, of angiotensin-converting enzyme inhibitors alone, and of beta blockers plus angiotensin-converting enzyme inhibitors on new coronary events and on congestive heart failure in older persons with healed myocardial infarcts and asymptomatic left ventricular systolic dysfunction

Of 477 asymptomatic persons, mean age 79 +/- 8 years, with prior myocardial infarction and a left ventricular ejection fraction less than or equal to 40%, 107 (22%) were treated with beta blockers alone, 89 (19%) with angiotensin-converting enzyme (ACE) inhibitors alone, 132 (28%) with beta blockers plus ACE inhibitors, and 149 (31%) with no beta blocker or ACE inhibitor, and followed for 31 +/- 19 months. The Cox regression model showed that compared with treatment with no beta blocker or ACE inhibitor, the percent reduction in new coronary events was 25% for beta blockers alone, 17% for ACE inhibitors alone, and 37% for beta blockers plus ACE inhibitors; the percent reduction in congestive heart failure was 41% for beta blockers alone, 32% for ACE inhibitors alone, and 60%, for beta blockers plus ACE inhibitors.