Extended follow-up of patients randomly assigned in the Angiotensin-converting enzyme inhibition Post-Revascularization Study (APRES)

American Heart Journal
L Kjøller-HansenP Grande

Abstract

We hypothesized that the benefit from ramipril on cardiac events and on left ventricular end-systolic volume (ESVI) in the Angiotensin-converting enzyme inhibition Post-revascularization Study (APRES) randomized controlled trial (RCT) was associated with long-term improvement. For the 3.2 years after the end of the RCT, we obtained information from a national database regarding date and cause of death and hospitalization for the 159 enrolled patients. Assignment to ramipril in the RCT resulted in a lower rate of cardiac death or hospitalization with heart failure up to the time of complete follow-up of all patients at 4.3 years (relative risk [RR], 0.28; P =.018) and up to 1.5 years after the end of the RCT (RR, 0.35; P =.042) but not up to the complete extended follow-up time at 6.9 years (RR, 0.65; P =.27). Independent predictors for risk of future cardiac death or hospitalization with heart failure were (a) left ventricular dilation (LVD) (RR, 2.84; P =.031), defined as an increase in ESVI greater than the reproducibility coefficient, and (b) composite event of acute myocardial infarction or development of heart failure or LVD (RR, 12.44; P <.001). Ramipril significantly reduced events (a) (P =.046) and (b) (P =.015) during ...Continue Reading

References

Jan 20, 2000·The New England Journal of Medicine·UNKNOWN Heart Outcomes Prevention Evaluation Study InvestigatorsG Dagenais
Mar 25, 2000·Journal of the American College of Cardiology·L Kjøller-HansenP Grande
Aug 13, 2003·Circulation·Thomas J WangRamachandran S Vasan
Sep 19, 2003·Lancet·K M Fox, UNKNOWN EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators
Oct 18, 2003·Journal of the American College of Cardiology·Eldrin F LewisUNKNOWN CARE Study
Jun 15, 2004·International Journal of Cardiology·Lars Kjøller-HansenPeer Grande

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Citations

Jul 6, 2014·Interactive Cardiovascular and Thoracic Surgery·Aiman AlassarJonathan Unsworth-White
Mar 31, 2015·Journal of Critical Care·Antonio Mangieri
Nov 8, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Benjamin Drenger, Charles Weissman
Aug 6, 2014·Cardiology in Review·Alessandro DuranteDomenico Cianflone
Mar 30, 2019·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·María Cespón-FernándezAndrés Íñiguez-Romo

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