Effects of angiotensin converting enzyme inhibitors on thrombotic mediators: potential clinical implications

Angiotensin-converting enzyme inhibitors (ACE-I) were initially developed as therapeutic agents targeted for the treatment of hypertension. Since the initial application of these agents, several additional clinical indications have been identified such as coronary artery disease, stroke, congestive heart failure and prevention of diabetes-related complications. In addition to the blood pressure lowering effects, this class of agents has the ability to restore endothelial function, decrease oxidative stress and enhance endogenous fibrinolysis. Moreover, ACE-I possesses antiplatelet effects as well as antiproliferatory and antimigratory effects on smooth muscle cells. This article links the effects of ACE-I on thrombotic mediators to the potential clinical implications in the setting of coronary artery disease.