Four RCTs (n=10,328) were included .
All studies scored the maximum 8 points for validity.
The authors stated that no significant heterogeneity was found for any of the analyses.
ACE inhibitors were associated with a statistically significant reduction in cardiovascular mortality (RR 0.851, 95% CI: 0.741, 0.977; 4 studies; p=0.022), fatal and nonfatal myocardial infarction (RR 0.792, 95% CI: 0.685, 0.916; 3 studies; p=0.002)and the need for invasive coronary revascularisation (RR 0.860, 95% CI: 0.762, 0.971; 2 studies; p=0.015).
There was no statistically significant difference between ACE inhibitors and placebo for all-cause mortality (RR 0.913, 95% CI: 0.825, 1.011; 4 studies), stroke (RR 0.901, 95% CI: 0.761, 1.067; 4 studies) or hospitalisation for congestive heart failure (RR 0.873, 95% CI: 0.717, 1.062; 3 studies).