Coronary artery disease - Impact of ramipril on the incidence of atrial fibrillation: Results of the Heart Outcomes Prevention Evaluation study
Coronary artery disease - Impact of ramipril on the incidence of atrial fibrillation: Results of the Heart Outcomes Prevention Evaluation study
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DOI：
10.1016/j.ahj.2007.04.062
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发表时间：
2007-09-01
影响因子：
4.8
通讯作者：
Lonn, Eva
中科院分区：
文献类型：
--
作者：
Salehian, Omid;Healey, Jeff;Lonn, Eva
目的我们评估血管紧张素转换酶（ACE）抑制剂雷米普利对心脏预后预防评估试验（Heart Outcomes Prevention Evaluation Atrial.Background）中入选患者房颤（AF）发生率的影响，房颤是影响普通人群的最常见心律失常，与发病率和死亡率增加相关。回顾性二级分析的一些大型试验的血管紧张素转换酶抑制剂表明，血管紧张素转换酶抑制剂'可以防止AF。方法我们评估了发生AF的审查心电图描记在进入，在2年，并在研究结束时，以及住院的8335名高风险参与者的心脏预后预防评估研究，>= 55岁，没有已知的心力衰竭或左心室（LV）收缩功能障碍，随访时间中位数为4.5年。我们比较了雷米普利和安慰剂对房颤发生的影响，并将结果与类似的试验进行了比较。结果随访4.5年，新发房颤的发生率较低（2.1%，177/8335），与安慰剂相比，雷米普利并没有显著降低新发房颤的发生率（86/4291 [2.0%] vs 91/4044 [2.2%]），比值比为0.92（95%置信区间，0.68-1.24; P = 0.57）。这些结果补充了以前的ACE抑制剂试验（不包括LV功能障碍患者的试验）显示，在接受这些药物治疗的患者中，新发AF没有显著减少（1088/20，930 [5.0%] vs 1343/22，878 [5.9%];相对危险度，0.92;结论虽然房颤的发生率较低，但在无左室收缩功能障碍的人群中，雷米普利治疗并不能显著降低这种心律失常。
Objectives We evaluated the effect of angiotensin-converting enzyme (ACE) inhibitor ramipril on the incidence of atrial fibrillation (AF) in patients enrolled in the Heart Outcomes Prevention Evaluation trial.Background Atrial fibrillation is the most common arrhythmia affecting the general population and is associated with increased morbidity and mortality. Retrospective secondary analyses of some of the large trials of ACE inhibitors have suggested that ACE inhibitors' may prevent AF.Methods We evaluated the occurrence of AF by reviewing the electrocardiogram tracings at entry, at 2 years, and at the end of the study, as well as hospitalizations among 8335 high-risk participants from the Heart Outcomes Prevention Evaluation study, >= 55 years, without known heart failure or left ventricular (LV) systolic dysfunction and followed for a median period of 4.5 years. We compared the impact of ramipril and matched placebo on occurrence of AF. The results were compared to similar trials.Results Over the 4.5 years follow-up, the incidence of new AF was low (2.1%, 177/8335), and ramipril did not significantly reduce the rate of new AF compared with placebo (86/4291 [2.0%] vs 91/4044 [2.2%]) with an odds ratio of 0.92 (95% confidence interval, 0.68-1.24; P = .57). These results added to the previous ACE inhibitor trials (excluding trials in patients with LV dysfunction) showed no significant reduction in new AF among patients treated with these agents (1088/20,930 [5.0%] vs 1343/22,878 [5.9%]; relative risk, 0.92; 95% confidence interval, 0.80-1.05).Conclusion Although the incidence of AF was low, treatment with ramipril in this population without known LV systolic dysfunction did not significantly reduce this dysrrhythmia.