Effects of ramipril on coronary events in high-risk persons : Results of the Heart Outcomes Prevention Evaluation study

In trials of patients with left ventricular dysfunction or heart failure, ACE inhibitor use was unexpectedly associated with reduced myocardial infarction (MI). Using the Heart Outcomes Prevention Evaluation (HOPE) trial data, we tested prospectively whether ramipril, an ACE inhibitor, could reduce...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2001-07, Vol.104 (5), p.522-526
Main Authors: DAGENAIS, Gilles R, YUSUF, Salim, BOURASSA, Martial G, QILONG YI, BOSCH, Jackie, LONN, Eva M, KOUZ, Simon, GROVER, John
Format: Article
Language:English
Subjects:
Aged
Angina, Unstable - prevention & control
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Biological and medical sciences
Cardiovascular system
Double-Blind Method
Female
Humans
Male
Medical sciences
Middle Aged
Miscellaneous
Myocardial Infarction - prevention & control
Myocardial Ischemia - prevention & control
Myocardial Revascularization - statistics & numerical data
Pharmacology. Drug treatments
Ramipril - therapeutic use
Risk Factors
Survival Analysis
Citations: Items that this one cites
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Summary:In trials of patients with left ventricular dysfunction or heart failure, ACE inhibitor use was unexpectedly associated with reduced myocardial infarction (MI). Using the Heart Outcomes Prevention Evaluation (HOPE) trial data, we tested prospectively whether ramipril, an ACE inhibitor, could reduce coronary events and revascularization procedures among patients with normal left ventricular function. In the HOPE trial, 9297 high-risk men and women, >/=55 years of age with previous cardiovascular disease or diabetes plus 1 risk factor, were randomly assigned to ramipril (up to 10 mg/d), vitamin E (400 IU/d), their combination, or matching placebos. During the mean follow-up of 4.5 years, there were 482 (10.4%) patients with clinical MI and unexpected cardiovascular death in the ramipril group compared with 604 (12.9%) in the placebo group [relative risk reduction (RRR), 21% (95% CI) (11,30); P
ISSN:0009-7322
1524-4539
DOI:10.1161/hc3001.093502