November 10, 1998Circulation
Postinfarction Survival and Inducibility of Ventricular Arrhythmias in the Spontaneously Hypertensive Rat
Key result
Ramipril decreased mortality to 56% compared with 78% for hydralazine and 82% for control (P=0.008) in spontaneously hypertensive rats post-myocardial infarction.
Why the study?
Does ramipril improve survival and reduce ventricular arrhythmias in spontaneously hypertensive rats post-myocardial infarction compared to hydralazine or control?
Population
136 spontaneously hypertensive rats with acute myocardial infarction produced by left anterior descending…
Comparison
Ramipril started 4 hours after infarction and… vs Hydralazine or control started 4 hours after…
Design
Preclinical, Rats were randomized to either control, hydralazine, or ramipril
Follow-up
8 weeks
Authors
Discussion
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Implication
Ramipril lowers post-MI mortality more than equivalent BP reduction with hydralazine in SHR; leaves open translation of ACEI antifibrotic effects to human hypertensive LVH.
Study Design
Type
RCT (n=136)
Randomization
randomized
Structured PICO
Does ramipril improve survival and reduce ventricular arrhythmias in spontaneously hypertensive rats post-myocardial infarction compared to hydralazine or control?
P
Population
136 spontaneously hypertensive rats with acute myocardial infarction, randomized to ramipril, hydralazine, or control for 8 weeks.
I
Intervention
Ramipril started 4 hours after infarction and continued for 8 weeks
C
Comparator
Hydralazine or control started 4 hours after infarction and continued for 8 weeks
O
Outcome
Mortality at 8 weekshard clinical
Main Result
Absolute Event Rate: 56% vs 82%
p-value: p=0.008
In a hypertensive rat model of myocardial infarction, the ACE inhibitor ramipril, but not the direct vasodilator hydralazine, significantly improved survival and reduced ventricular arrhythmias, left ventricular hypertrophy, and cardiac fibrosis.
Cite This Study
Nguyen et al. (1998) conducted an RCT in Acute myocardial infarction with hypertension and left ventricular hypertrophy (n=136). Ramipril vs. Hydralazine or control was evaluated on Mortality (p=0.008). Ramipril decreased mortality to 56% compared with 78% for hydralazine and 82% for control (P=0.008) in spontaneously hypertensive rats post-myocardial infarction.