1992Heart failureAcute coronary syndromes2231 patients

SAVE

Therapy group: ACE inhibitors · Therapy: Captopril after myocardial infarction

After myocardial infarction with left ventricular dysfunction but no overt heart failure, captopril improved survival and reduced major cardiovascular events.

Published in N Engl J Med (1992)

Question: Can captopril, an angiotensin-converting-enzyme inhibitor, reduce morbidity and mortality in patients with left ventricular dysfunction after myocardial infarction?
Design: Randomized, double-blind, placebo-controlled trial of 2231 patients assigned to placebo (1116) or captopril (1115) 3 to 16 days after infarction. Average follow-up was 42 months.
Population: Patients after myocardial infarction with an ejection fraction of 40% or less, without overt heart failure or symptoms of myocardial ischemia.
Intervention: Long-term captopril, given double-blind.
Control: Placebo.
Primary outcome: All-cause mortality. Fatal and nonfatal major cardiovascular events were also assessed, including cardiovascular death, severe heart failure, hospitalization for heart failure and recurrent infarction.
Results: All-cause mortality was lower with captopril (228 deaths, 20%) than with placebo (275 deaths, 25%), a 19% risk reduction (95% CI, 3 to 32%; P = 0.019). Among secondary results, development of severe heart failure was reduced by 37% (95% CI, 20 to 50%; P < 0.001).
Conclusion: In patients with asymptomatic left ventricular dysfunction after infarction, long-term captopril improved survival and reduced major cardiovascular events.
Why it matters: It showed that starting an ACE inhibitor in the subacute phase of infarction in patients with depressed ventricular function adds benefit on top of standard therapy, and helped establish this strategy in secondary prevention.

Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.

Generated on October 18, 2026

Sources

Original publication on PubMed (PMID 1386652) ↗Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators.
Journal article (DOI) ↗

Videos explaining it

SAVE Trial

HMC · Residencia de Cardiología HMC ↗15:51Video page

Source: Residencia de Cardiología HMC · YouTube
Date: 18 Oct 2016
Audio: Spanish
Subtitles: MultilingualYouTube
Audio transl.: None

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Podcasts explaining it

Review of Survival and Ventricular Enlargement (SAVE) Trial
Cardiology Trials · Cardiology Trials ↗10 minEpisode page
Source
Cardiology Trials · Apple Podcasts
Date
30 Jan 2024
Audio
English
Translation
TextGoogle Chrome
Audio transl.
None

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