Impact of ramipril on the circadian periodicity of acute myocardial infarction.

Abstract

Onset of acute myocardial infarction (AMI) follows a diurnal periodicity, with a peak incidence between 6:00 a.m. and noon. Beta blockers and aspirin decrease the rate of AMI and blunt the peak incidence, but such an effect has not been evaluated for angiotensin-converting enzyme inhibitors. The effect of ramipril on onset of symptomatic AMI was evaluated in 4-hour periods over a 24-hour cycle in men and women who were > or =55 years of age, had cardiovascular disease or diabetes mellitus with > or =1 other risk factor, and participated in the Heart Outcomes Prevention Evaluation (HOPE) trial. During the 4.5-year follow-up, AMI was documented in 383 of 4,596 participants allocated to ramipril and in 491 of 4,598 participants allocated to placebo (8.3% vs 10.7%, p <0.001). Ramipril decreased rates of AMI at each period and attenuated, but did not blunt, the peak incidence. In conclusion, inhibiting angiotensin-converting enzyme decreased AMI over a 24-hour period, but this enzyme does not seem to play a major role in the circadian periodicity of this acute event.

• Authors: Gilles R Dagenais, Janice Pogue, Koon K Teo, Eva M Lonn, Salim Yusuf, HOPE Study Investigators
• Journal: The American journal of cardiology (Am J Cardiol) Vol. 98 Issue 6 Pg. 758-60 (Sep 15 2006) ISSN: 0002-9149 [Print] United States
• PMID: 16950179 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Angiotensin-Converting Enzyme Inhibitors
• Ramipril

Topics

• Angiotensin-Converting Enzyme Inhibitors (therapeutic use)
• Circadian Rhythm
• Female
• Follow-Up Studies
• Humans
• Male
• Myocardial Infarction (epidemiology, prevention & control)
• Ramipril (therapeutic use)
• Randomized Controlled Trials as Topic