SynthesisBMJ (Clinical research ed.)2017
Renin angiotensin system inhibitors for patients with stable coronary artery disease without heart failure: systematic review and meta-analysis of randomized trials.
Synthesis in BMJ (Clinical research ed.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 100 citations in OpenAlex.
- Rationale for the Use of Fixed Combination Therapies with Angiotensin Converting Enzyme Inhibitors and Beta-Blockers in Patients with Essential Hypertension and High Cardiovascular Risk: A Consensus Document from the Italian Society of Arterial Hypertension (Siia) and the Italian Society of Cardiovascular Prevention (SIPREC).High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2026Guideline
- The Impact of Statin and Angiotensin-Converting Enzyme Inhibitor/Angiotensin Receptor Blocker Therapy on Cognitive Function in Adults With Human Immunodeficiency Virus Infection.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2017Trial
- Impact of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on cardiovascular and non-cardiovascular outcomes in patients at high/very-high cardiovascular risk without heart failure: a systematic review and meta-analysis of randomized, double-blind, placebo-controlled trialsEuropean heart journal open · 2026Article
- Discontinuation of Renin-Angiotensin System Inhibitors during Acute Kidney Injury Episode and All-Cause Mortality: Target Trial Emulation Studies.Journal of the American Society of Nephrology : JASN · 2025Article
- Guideline for Chronic Coronary Syndrome - 2025.Arquivos brasileiros de cardiologia · 2025Article
- Engineering Nanoparticles and Bioscaffolds for Targeted microRNA Delivery in Cardiovascular Regeneration-A Comprehensive Review.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2025Review
- Sodium-Glucose Transporter-2 Inhibitors (SGLT2i) and Myocardial Ischemia: Another Compelling Reason to Consider These Agents Regardless of Diabetes.International journal of molecular sciences · 2025Review
- Strategies for the Secondary Prevention of Atherosclerotic Cardiovascular Disease.US cardiology · 2025Review
- Heterogeneous and Composite Bioinks for 3D-Bioprinting of Complex Tissue.Biomedical materials & devices (New York, N.Y.) · 2025Review
- Polypills in the Management of Cardiovascular Risk-A Perspective.Journal of clinical medicine · 2024 · on this mapArticle
- Strategies for chronic coronary disease: A brief guide for clinicians.NPJ cardiovascular health · 2024Review
- Effect of renin angiotensin system inhibitors on long-term major cardiovascular outcomes in patients with high atherosclerotic cardiovascular risk.Scientific reports · 2023Observational
- Modeling global 80-80-80 blood pressure targets and cardiovascular outcomes.Nature medicine · 2022Article
- Effect of Empagliflozin on Sphingolipid Catabolism in Diabetic and Hypertensive Rats.International journal of molecular sciences · 2022Article
- Edema formation in congestive heart failure and the underlying mechanisms.Frontiers in cardiovascular medicine · 2022Review
- Prognostic Impacts of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Acute Coronary Syndrome Patients Without Heart Failure.Frontiers in pharmacology · 2022Article
- Saudi Heart Association Guidelines on Best Practices in the Management of Chronic Coronary Syndromes.Journal of the Saudi Heart Association · 2022Article
- Alternative RAS in Various Hypoxic Conditions: From Myocardial Infarction to COVID-19.International journal of molecular sciences · 2021Review
- Extrinsically Conductive Nanomaterials for Cardiac Tissue Engineering Applications.Micromachines · 2021Review
- Article
Corrections and comments
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Authors and funding
6 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo critically evaluate the efficacy of renin angiotensin system inhibitors (RASi) in patients with coronary artery disease without heart failure, compared with active controls or placebo.
designMeta-analysis of randomized trials. DATA SOURCES: PubMed, EMBASE, and CENTRAL databases until 1 May 2016. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Randomized trials of RASi versus placebo or active controls in patients with stable coronary artery disease without heart failure (defined as left ventricular ejection fraction ≥40% or without clinical heart failure). Each trial had to enroll at least 100 patients with coronary artery disease without heart failure, with at least one year's follow-up. Studies were excluded if they were redacted or compared use of angiotensin converting enzyme inhibitors with angiotensin receptor blockers. Outcomes were death, cardiovascular death, myocardial infarction, angina, stroke, heart failure, revascularization, incident diabetes, and drug withdrawal due to adverse effects.
results24 trials with 198 275 patient years of follow-up were included. RASi reduced the risk of all cause mortality (rate ratio 0.84, 95% confidence interval 0.72 to 0.98), cardiovascular mortality (0.74, 0.59 to 0.94), myocardial infarction (0.82, 0.76 to 0.88), stroke (0.79, 0.70 to 0.89), angina, heart failure, and revascularization when compared with placebo but not when compared with active controls (all cause mortality, 1.05, 0.94 to 1.17; P
conclusionsIn patients with stable coronary artery disease without heart failure, RASi reduced cardiovascular events and death only when compared with placebo but not when compared with active controls. Even among placebo controlled trials in this study, the benefit of RASi was mainly seen in trials with higher control event rates but not in those with lower control event rates. Evidence does not support a preferred status of RASi over other active controls.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.