The Acute Infarction Ramipril Efficacy (AIRE) trial (39) randomized patients with early pulmonary congestion after infarction (Killip Class > 1) to ramipril or placebo. Ramipril was given as 1.25-2.5 mg 2X daily, titrated up to 5 mg 2X daily for an average of 15 mo. There was a 27% reduction in risk of death from all causes (from 23% in placebo patients to 17% in treated patients) (Fig. 3). Furthermore, there was a reduction of 19% in the first occurrence of a prespecified combined end point of death, severe heart failure, MI, or stroke. AIRE required clinical evidence of pulmonary congestion.

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