Objective. This study sought to investigate the effects of early and long-term intervention with an- giotensin-converting enzyme（ACE） inhibitor captopril on the elderly patients with acute myocardial in farc- tion（AMI）

and observe its in-hospital and post-hospital outcomes during serial follow-up of 54 months. Methods. 631 elderly patients（60～75 years old） with AMI and without cardiogenic shock were hospi- talized within 72 hours of symptoms and were randomly allocated to captopril （n = 361;treatment group） and conventional treatment （n = 270; control group）. The survival and cardiac events （congestive heart fail- ure

reinfarction

severe arrhythmias and cardiac death）of each group were determined during hospitaliza-tion and follow-up. Results. During hospitalization

the survival was higher in treatment group than in control group（p< 0. 0001 ）. On the other hand

in treatment group lower mortality was true for patients with anterior my- ocardial infarction（p < 0. 001 ） or with anterior+inferior myocardial infarction （P= 0. 026 ）

but not statis- tically significant in ones with inferior myocardial infarction （P= 0. 061 ）. During follow-up

the occurrence of cardiac death

heart failure

reinfarction and severe arrhythmias were lower in treatment group （P = 0. 0001

P = 0. 05

P = 0. 0004 and P = 0. 027）. So higher survival （P = 0. 005 ） and lower total cardiac events（p= 0. 0008） could be seen in treatment group over this period. Conclusions. Early and long-term treatment with captopril in the elderly patients with AMI has bene-ficial outcomes in both in-hospital and follow-up periods.