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| Slide Lecture Programs |
| 2000 Core Curriculum |
| The endothelium: New insights into the origins and treatment of CAD |
August 31, 2000
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| VIII: |
The tissue ACE trials
- In the APRES study, after PTCA or CABG, 159 patients with preoperative chronic stable angina pectoris, left ventricular ejection fraction between 30% and 50%, and no clinical heart failure were randomly assigned to receive double-blind treatment with either ramipril or placebo and followed for a median of 33 months.95
- Ramipril reduced the incidence of the triple-composite end point of cardiac death, acute MI, or clinical heart failure (risk reduction 58%; 95% confidence interval 7% to 80%, P = .03).
- Treatment with ramipril did not alter the incidence of the quadruple-composite end point of cardiac death, acute MI, clinical heart failure, or recurrent angina pectoris.
- These findings were consistent across subgroups, that is, those with left ventricular ejection fractions below or above 40%, and whether CABG or PTCA was performed.
- For single events, the risk of cardiac death was lowered by 86% with ramipril (P = .03). The reductions in clinical heart failure and MI were not statistically significant.
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