2013;8(9):277. Cardiologia CROATICA Objectives: To compare the efficacy of ramipril and losartan in prevention of the left ventricular systolic dysfunction and heart failure in ST-elevation myocardial infarction (STEMI) patients treated by primary percutaneous coronary intervention (PPCI) in short (8 weeks) and long-term (six months) after acute coronary event. Patients and Methods: 55 STEMI patients (mean age 58.4 ±9.9 years, 63.6% of men) in Killip classes I-II were included; excluded were

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... patients with pulmonary edema, cardiogenic shock, brochospasm. All the patients underwent PPCI. 29 patients were randomly assigned to receive ramipril and 26 to losartan 24 to 48 hours after PPCI. Systolic function was estimated by echocardiography prior to randomization, 8 weeks and 6 months thereafter. Ejection fraction (EF) was measured by modified biplane Simpson's method (normal levels >55%), left ventricular end-diastolic diameter (LVDD) in standard echocardiographic positions (normal levels <50 mm). NT-proBNP was estimated prior to randomization, 8 weeks and six months after randomization by the electrochemiluminescence immunoassay (Elecsys 2010 analyzer, Roche Diagnostics). Results: Mean baseline EF was 53.2±8.9%, NT-proBNP 220.0±190.5 pmol/l, LVDD 74.76±5.7 mm. EF <55% was present in 50.9%, LVDD >50 mm in 43.6% and NT-proBNP >200 pmol/l in 47.2% of patients. We did not demonstrate any significant differences between ramipril and losartan group neither at baseline nor after 8 weeks and six months of treatment in mean EF, LVDD and NT-proBNP. Within ramipril group as well as within losartan group there was an Literature 1. Werner C, Baumhäkel M, Teo KK, et al. RAS blockade with ARB and ACE inhibitors: current perspective on rationale and patient selection. Clin Res Cardiol. 2008;97(7):418-431.