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Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors and/or Angiotensin II Receptor Blockers Added to Standard Medical Therapy for Treating Patients With Stable Ischemic Heart Disease and Preserved Left Ventricular Systolic Function

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Standard Therapy for Stable Ischemic Heart Disease

In patients with stable ischemic heart disease, antiplatelet therapy with a single agent (aspirin or clopidogrel) and statin therapy (if the concentrations of low-density lipoprotein and non–high-density lipoprotein are above 100 mg/dL and 130 mg/dL, respectively) can reduce the risk of cardiovascular events (Gibbons et al., 2002; Fraker and Fihn, 2007). Other drugs — such as fast-acting nitrates (nitroglycerin tablets or spray), negative chronotropic agents (β-blockers; nondihydropyridine calcium channel blockers), and vasodilators (calcium channel blockers; long-acting nitrates) — can be used in patients with stable ischemic heart disease to relieve symptoms but do not impact the risk of cardiovascular events (Gibbons et al., 2002; Fraker and Fihn, 2007). For this reason, it is important to evaluate new therapeutic modalities that may impact cardiovascular events in patients with stable ischemic heart disease in addition to standard medical therapy.