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Abstract
It has been established from multiple randomised, placebo-controlled trials that angiotensin-converting enzyme inhibitors reduce the risk of death and major non-fatal cardiovascular events after acute myocardial infarction, especially when these agents are used for long-term treatment in high-risk patients. Angiotensin receptor blockers represent a theoretically appealing class of drugs for use in combination with or as alternatives to angiotensin-converting enzyme inhibitors in such patients. The Valsartan in Acute Myocardial Infarction (VALIANT) trial compared the effects of valsartan, captopril and the combination of both in a population of high-risk patients with evidence of left ventricular dysfunction after acute myocardial infarction. This article discusses this important study and its implications for the clinical management of these high-risk patients.