Study population
acute infection, myocardial infarction, malignancy, liver disease, cough, angioedema
ACUTE INFECTION, MYOCARDIAL INFARCTION, EVENT, LIVER DISEASE, ANGIOEDEMA, CONNECTIVE TISSUE DISEASE, GASTROINTESTINAL DYSFUNCTION
The study was approved by the Vanderbilt University Institutional Review Board and performed according to the Declaration of Helsinki. Two-hundred and two patients were pre-screened for eligibility, and 16 patients were approached and assessed for eligibility. Patients with a history of functional transplant less than six months prior to the study or anticipated live donor kidney transplant were excluded. Patients with a history of active connective tissue disease, acute infection within one month prior to the study, advanced liver disease, gastrointestinal dysfunction requiring parental nutrition, or active malignancy were not included in the study. Use of the following medications was also excluded: anti-inflammatory medication other than aspirin at a dose less than 325 mg per day, immunosuppressive drugs within one month prior to the study, vitamin E at a dose higher than 60 IU per day, or vitamin C at a dose higher than 500 mg per day. Subjects with a history of myocardial infarction or cerebrovascular event within three months prior to the study or with an ejection fraction lower than 40% were excluded. Other exclusion criteria were a history of ACEi-associated angioedema or cough, pregnancy, or breastfeeding. Three patients were excluded based on their inability to undergo magnetic resonance imaging (MRI). Thirteen patients provided written informed consent and agreed to participate in the study, but two withdrew from participation before any intervention. Therefore, 11 patients completed the study. Figure 
Flowchart of study participation and randomization