Should all patients after myocardial infarction receive an angiotensin-converting enzyme (ACE) inhibitor?
Gerd Hasenfuß, MD: No. An ACE inhibitor is maybe needed if the patient has hypertension. But it should be definitely given in patients after myocardial infarction with reduced ejection fraction <40%.
It is needed in patients with ejection fraction <40% with heart failure symptoms or without symptoms, because it has been shown long ago that even in patients with New York Heart Association heart failure class I if the ejection fraction is reduced, you can have preventive measures with an ACE inhibitor, in particular after myocardial infarction.