Effects of an angiotensin-converting enzyme inhibitor (ramipril) on inflammatory markers in secondary prevention patients: RAICES Study

• Published in: Coronary artery disease Vol. 16; no. 7; pp. 423 - 429
• Main Authors: Lopez Santi, Ricardo G, Valeff, Eduardo C, Duymovich, Claudio R, Mazziotta, Daniel, Mijailovsky, Norma E, Filippa, Gerardo C, Maltez, Raúl, Hernandez, Violeta A, Monroy, Alejandro Gomez, Borzi, Jorge G, Acheme, Rosana A, Etchegoyen, María C
• Format: Journal Article
• Language: English
• Published: England Lippincott Williams & Wilkins, Inc 01-11-2005
• Subjects: Aged; Angiotensin-Converting Enzyme Inhibitors - pharmacology; C-Reactive Protein - analysis; C-Reactive Protein - drug effects; Cardiovascular Diseases - prevention & control; Drug Therapy, Combination; Female; Humans; Inflammation - prevention & control; Male; Middle Aged; Ramipril - pharmacology; Risk Factors; Secondary Prevention
• ISSN: 0954-6928; 1473-5830
• DOI: 10.1097/00019501-200510000-00002

AIMSTo evaluate the hypothesis that angiotensin-converting enzyme inhibitor therapy with ramipril reduces baseline levels of C-reactive protein in patients at high cardiovascular risk.
METHODSSecondary prevention patients were screened for eligibility and treated with ramipril for 6 month. Baseline and 6-month highly sensitive C-reactive protein levels were determined.
RESULTSA total of 77 patients were analyzed. The median highly sensitive C-reactive protein concentration at baseline was 2.17 mg/l (interquartile interval 0.97–4.54); whereas in post-treatment, the median was 1.70 mg/l (interquartile interval 0.88–3.41), P=0.0009. Patients were stratified according to risk level determined by baseline highly sensitive C-reactive protein levelslow-risk (<1 mg/l), intermediate risk (1–3 mg/l) and high risk (>3 mg/l) The reduction in highly sensitive C-reactive protein occurred at the expense of the high-risk group (baseline 5.02 mg/l, post-treatment 3.3 mg/l, P<0.0001), with no differences in the other groups. In multiple regression analysis, the reduction observed in the high-risk group could not be explained by baseline treatment or change in any of the variables analyzed.
CONCLUSIONHighly sensitive C-reactive protein levels were reduced after a 6-month ramipril therapy in secondary prevention patients, suggesting an anti-inflammatory effect of angiotensin-converting enzyme inhibitors. Future investigations will be done to confirm these results, and to investigate how angiotensin-converting enzyme inhibitor treatment elicits anti-inflammatory effects.