ramipril and Atrial-Fibrillation

ramipril has been researched along with Atrial-Fibrillation* in 15 studies

Trials

8 trial(s) available for ramipril and Atrial-Fibrillation

ArticleYear
Prevention of Atrial Fibrillation After Atrial Flutter Ablation With Ramipril (from the PREFACE Study).
    The American journal of cardiology, 2022, 01-01, Volume: 162

    The clinical efficacy of the inhibitors of the renin-angiotensin-aldosterone system (RAAS) as an upstream therapy for atrial fibrillation (AF) prevention is controversial. No study has itemized so far the role of RAAS inhibitors in AF prevention after atrial flutter (AFL) ablation. This trial aims to investigate the effect of ramipril compared with placebo on AF occurrence in patients hospitalized for AFL ablation without structural heart disease. The Prevention of Atrial Fibrillation by Inhibition Conversion Enzyme (ICE) After Radiofrequency Ablation of Atrial Flutter (PREFACE) trial was a prospective, multicenter, randomized, double-blind, double-dummy trial depicting the AF occurrence during a 12-month follow-up as the primary end point. A total of 198 patients hospitalized for AFL ablation were enrolled in the trial and randomized to placebo or ramipril 5 mg/day. Patients were followed up during 1 year after AFL ablation using 1-week Holter electrocardiogram at 3, 6, 9, and 12 months. The intention-to-treat population encompassed 97 patients in the ramipril group and 101 patients in the placebo group. The primary end point, such as AF occurrence during the 1-year follow-up, was not different between the 2 groups (p = 0.96). Secondary end points, including the occurrence of supraventricular arrhythmia (p = 0.50), heart failure, stroke, and death, were not different between the 2 groups. Safety outcome parameters, including serious adverse events leading to treatment disruption (p = 0.10), hypotension, impairment of renal function, and elevated serum potassium level, also were not different between the 2 groups. In conclusion, RAAS inhibition using ramipril does not reduce AF occurrence in patients facing AFL ablation during the 1-year follow-up.

    Topics: Aged; Angiotensin-Converting Enzyme Inhibitors; Atrial Fibrillation; Atrial Flutter; Catheter Ablation; Double-Blind Method; Electrocardiography, Ambulatory; Female; Follow-Up Studies; Hospitalization; Humans; Kaplan-Meier Estimate; Male; Middle Aged; Prospective Studies; Ramipril; Recurrence; Treatment Outcome

2022
Effect of telmisartan and ramipril on atrial fibrillation recurrence and severity in hypertensive patients with metabolic syndrome and recurrent symptomatic paroxysmal and persistent atrial fibrillation.
    Journal of cardiovascular pharmacology and therapeutics, 2012, Volume: 17, Issue:1

    This study evaluated the effect of telmisartan, ramipril, and amlodipine on atrial fibrillation (AF) recurrence and severity in hypertensive patients with metabolic syndrome. A total of 391 hypertensive outpatients with metabolic syndrome, in sinus rhythm but with at least 2 episodes of AF in the previous 6 months were randomized to telmisartan, ramipril, or amlodipine for 1 year. At the first AF, ventricular rate (VR) and plasma cardiac troponin I (TnI) were evaluated. P-wave dispersion (PWD) and procollagen type I carboxy-terminal peptide (PIP) were evaluated before and after 12 months of treatment. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were similarly and significantly reduced by all treatments (P < .001). In all, 49% of patients treated with amlodipine had a recurrence of AF as did 25.5% of patients with ramipril and 12.9% of patients with telmisartan (P < .01 vs amlodipine and P < .05 vs ramipril). Ventricular rate and TnI at the first AF recurrence were significantly lower with telmisartan and ramipril than with amlodipine. P-wave dispersion was reduced by ramipril (-5.1 ms, P < .05) and even more by telmisartan (-11 ms, P < .01). Telmisartan and ramipril induced a similar PIP reduction (-52.8 and -49.8 µg/L, respectively, P < .01). These findings suggested that in these patients telmisartan was more effective than ramipril in reducing AF recurrence and severity as well as in improving PWD, despite a similar BP reduction and a similar improvement in cardiac fibrosis. This could be related to a specific effect of telmisartan on atrial electric remodeling.

    Topics: Aged; Atrial Fibrillation; Benzimidazoles; Benzoates; Double-Blind Method; Female; Follow-Up Studies; Humans; Hypertension; Male; Metabolic Syndrome; Prospective Studies; Ramipril; Secondary Prevention; Severity of Illness Index; Telmisartan; Treatment Outcome

2012
Blood pressure and other determinants of new-onset atrial fibrillation in patients at high cardiovascular risk in the Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial/Telmisartan Randomized AssessmeNt Study in ACE iNtoleran
    Journal of hypertension, 2012, Volume: 30, Issue:5

    Evidence on new-onset atrial fibrillation in high-risk vascular patients without heart failure is limited. New-onset atrial fibrillation was a prespecified secondary objective of the Ongoing Telmisartan Alone and in Combination With Ramipril Global Endpoint Trial (ONTARGET)/Telmisartan Randomized AssessmeNt Study in ACE iNtolerant subjects with cardiovascular Disease (TRANSCEND) studies.. We studied 30 424 ONTARGET/TRANSCEND patients (mean age ± SD, 66.4 ± 7.0) with vascular disease or complicated diabetes who were in sinus rhythm at entry. A copy of ECG was sent to central office every time new atrial fibrillation was detected by investigators.. During a median follow-up period of 4.7 years, new atrial fibrillation occurred in 2092 patients (15.1 per 1000  patient-years). Risk of atrial fibrillation increased with age, SBP and pulse pressure, left ventricular hypertrophy, BMI, serum creatinine and history of hypertension, coronary artery disease and cerebrovascular disease (all P < 0.01). After adjustment for BMI and other variables, atrial fibrillation risk increased with hip circumference. History of hypertension was associated with a 34% higher risk of new atrial fibrillation. New atrial fibrillation portended an increased risk of congestive heart failure [hazard ratio 2.89, 95% confidence interval (CI) 2.45-3.40, P < 0.01] and cardiovascular death (hazard ratio 1.22, 95% CI 1.05-1.41, P < 0.01). Risk of stroke was unaffected (hazard ratio 1.14, 95% CI 0.93-1.40), whereas that of myocardial infarction was reduced (hazard ratio 0.64, 95% CI 0.50-0.82). Patients with new atrial fibrillation were more likely to receive vitamin K antagonists (P < 0.01), statins (P < 0.05) and β-blockers (P < 0.01) than those in sinus rhythm.. New atrial fibrillation is common in high-risk vascular patients and is associated with several risk factors including history of hypertension. Hip circumference was the strongest anthropometric predictor. Despite extensive use of modern therapies, new atrial fibrillation carries a high risk of congestive heart failure and death over a relatively short term.

    Topics: Aged; Angiotensin II Type 1 Receptor Blockers; Anthropometry; Atrial Fibrillation; Benzimidazoles; Benzoates; Body Mass Index; Cardiovascular Diseases; Diabetes Complications; Double-Blind Method; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypertrophy, Left Ventricular; Male; Middle Aged; Placebos; Ramipril; Risk; Risk Factors; Stroke; Telmisartan; Vitamin K

2012
Angiotensin-converting enzyme inhibition or mineralocorticoid receptor blockade do not affect prevalence of atrial fibrillation in patients undergoing cardiac surgery.
    Critical care medicine, 2012, Volume: 40, Issue:10

    This study tested the hypothesis that interruption of the renin-angiotensin system with either an angiotensin-converting enzyme inhibitor or a mineralocorticoid receptor antagonist will decrease the prevalence of atrial fibrillation after cardiac surgery.. Randomized double-blind placebo-controlled study.. University-affiliated hospitals.. Four hundred forty-five adult patients in normal sinus rhythm undergoing elective cardiac surgery.. One week to 4 days prior to surgery, patients were randomized to treatment with placebo, ramipril (2.5 mg the first 3 days followed by 5 mg/day, with the dose reduced to 2.5 mg/day on the first postoperative day only), or spironolactone (25 mg/day).. The primary endpoint was the occurrence of electrocardiographically confirmed postoperative atrial fibrillation. Secondary endpoints included acute renal failure, hyperkalemia, the prevalence of hypotension, length of hospital stay, stroke, and death.. The prevalence of atrial fibrillation was 27.2% in the placebo group, 27.8% in the ramipril group, and 25.9% in the spironolactone group (p=.95). Patients in the ramipril (0.7%) or spironolactone (0.7%) group were less likely to develop acute renal failure than those randomized to placebo (5.4%, p=.006). Patients in the placebo group tended to be hospitalized longer than those in the ramipril or spironolactone group (6.8±8.2 days vs. 5.7±3.2 days and 5.8±3.4 days, respectively, p=.08 for the comparison of placebo vs. the active treatment groups using log-rank test). Compared with patients in the placebo group, patients in the spironolactone group were extubated sooner after surgery (576.4±761.5 mins vs. 1091.3±3067.3 mins, p=.04).. Neither angiotensin-converting enzyme inhibition nor mineralocorticoid receptor blockade decreased the primary outcome of postoperative atrial fibrillation. Treatment with an angiotensin-converting enzyme inhibitor or mineralocorticoid receptor antagonist was associated with decreased acute renal failure. Spironolactone use was also associated with a shorter duration of mechanical ventilation after surgery.

    Topics: Aged; Angiotensin-Converting Enzyme Inhibitors; Atrial Fibrillation; Blood Pressure; Cardiac Surgical Procedures; Double-Blind Method; Electrocardiography; Female; Hospitals, University; Humans; Male; Middle Aged; Ramipril; Receptors, Mineralocorticoid; Renin-Angiotensin System; Spironolactone

2012
Prevention of recurrent lone atrial fibrillation by the angiotensin-II converting enzyme inhibitor ramipril in normotensive patients.
    Journal of the American College of Cardiology, 2009, Jan-06, Volume: 53, Issue:1

    The aim of the present study was to verify whether angiotensin-II converting enzyme (ACE) inhibition is also effective in preventing relapses of lone atrial fibrillation (LAF), that is, in the absence of hypertension and/or heart disease.. Several studies have shown that ACE inhibitors are effective in preventing atrial fibrillation (AF) relapses in patients with arterial hypertension or several forms of heart disease, that is, in the presence of clinical conditions that are recognized as causing a higher risk of atrial arrhythmias.. Sixty-two patients admitted to the emergency department of our institution for a first-ever episode of LAF were enrolled in the study after excluding the presence of cardiac or extracardiac conditions known to be associated with an increased risk of AF, by medical history, physical examination, complete echocardiographic study, and the evaluation of blood pressure, thyroid function, urinary catecholamines, serum electrolytes, blood glucose, red blood cell count, and arterial blood gases. After cardioversion to sinus rhythm by intravenous propafenone, patients were randomized to either ramipril 5 mg/day (n = 31) or placebo (n = 31). Holter monitoring and clinical examination were performed every 3 months.. After a 3-year follow-up, AF relapses were observed in 3 patients treated with ramipril and in 10 patients allocated to placebo (p < 0.03, Kaplan-Meier, log-rank test). During follow-up, none of the patients developed arterial hypertension or other cardiac or extracardiac condition known to be associated with increased risk of AF, that is, in all patients the diagnosis of LAF was confirmed.. Ramipril is effective in preventing relapses of LAF.

    Topics: Angiotensin-Converting Enzyme Inhibitors; Atrial Fibrillation; Female; Humans; Male; Middle Aged; Ramipril; Secondary Prevention; Treatment Outcome

2009
[Role of ACE-inhibitors in preventing atrial fibrillation relapses in normotensive patients].
    Recenti progressi in medicina, 2009, Volume: 100, Issue:11

    Atrial fibrillation (AF) is the most common chronic cardiac arrhythmia and a major public health problem, leading to high rates of morbidity and mortality. The most prevalent cause of AF in the western world is hypertensive heart disease. Blood pressure increase leads to hemodynamic modifications which usually have direct effects on left ventricular and atrial structure and function. The renin-angiotensin-aldosterone system (RAAS) plays an important role in regulating blood volume and systemic vascular resistance. Furthermore, recent studies showed that RAAS plays a key role in left atrial and ventricle structural and functional remodeling. Experimental studies and clinical trials have shown that angiotensin-II converting enzyme (ACE) inhibitors and angiotensin-II receptor blockers are effective in preventing atrial fibrillation in patients with arterial hypertension or several forms of heart disease. In our study, we showed that ramipril is effective in preventing AF relapses in patients with lone AF (LAF: i.e AF in the absence of clinical and echocardiographic evidence of cardiovascular, pulmonary, or endocrine disease), independently of any sizeable effect on cardiac echocardiographic anatomy when compared with baseline data. In this paper, we briefly discuss: 1) the role of ACE inhibitor ramipril in preventing AF relapses in LAF patients; 2) the underlying mechanisms by which it can potentially act; 3) the possibility of considering the occurrence of LAF as a marker of subclinical organ damage in subjects with blood pressure values in the 130 to 139 mm Hg range, that is in the pre-hypertension classification according to the JNC-7 Report, of high normal blood pressure levels according to the 2007 ESC/ESH guidelines.

    Topics: Angiotensin-Converting Enzyme Inhibitors; Antihypertensive Agents; Atrial Fibrillation; Blood Pressure; Clinical Trials as Topic; Double-Blind Method; Follow-Up Studies; Humans; Hypertension; Placebos; Practice Guidelines as Topic; Ramipril; Risk Factors; Secondary Prevention; Time Factors

2009
Effect of valsartan and ramipril on atrial fibrillation recurrence and P-wave dispersion in hypertensive patients with recurrent symptomatic lone atrial fibrillation.
    American journal of hypertension, 2008, Volume: 21, Issue:9

    This study compared the effect of antihypertensive treatment with valsartan or ramipril on atrial fibrillation (AF) recurrence, on P-wave dispersion, (PWD) and on serum procollagen type I carboxy terminal peptide (PIP).. A total of 369 mild hypertensive (systolic blood pressure (SBP) >140 and/or 90 < diastolic blood pressure (DBP) < 110 mm Hg) outpatients in sinus rhythm but with at least two episodes of AF in the previous 6 months were randomized to valsartan (n = 122), ramipril (n = 124), or amlodipine (n = 123) for 1 year. Clinic blood pressure (BP) and a 24-h electrocardiogram (ECG) were evaluated monthly. Patients were asked to report any episode of symptomatic AF and to perform an ECG as early as possible. PWD and serum PIP levels were evaluated before and after each treatment period.. SBP and DBP were significantly reduced by the three treatments (P < 0.001). A total of 46 (47.4%) patients treated with amlodipine had a recurrence of AF as did 26 (27.9%) patients treated with ramipril (P < 0.01 vs. amlodipine) and 16 (16.1%) patients treated with valsartan (P < 0.01 vs. amlodipine and P < 0.05 vs. ramipril). The Kaplan-Meyer analysis showed a significant reduction of AF episodes in the valsartan group (P = 0.005 log-rank test) as well as in the ramipril group (P = 0.021), even if at a lesser degree. PWD values were significantly reduced by ramipril (-4.2 ms, P < 0.05) and even more by valsartan (-11.2 ms, P < 0.01), the difference being significant (P < 0.01). Serum PIP levels were reduced by ramipril (-49.7 microg, P < 0.001) and valsartan (-49.3 microg, P < 0.001).. Despite similar BP lowering, valsartan and ramipril were more effective than amlodipine in preventing new episodes of AF, but the effect of valsartan was greater than that of ramipril. This could be related to the greater PWD reduction observed with valsartan.

    Topics: Aged; Amlodipine; Antihypertensive Agents; Atrial Fibrillation; Double-Blind Method; Electrocardiography; Female; Humans; Male; Peptide Fragments; Procollagen; Ramipril; Recurrence; Tetrazoles; Valine; Valsartan

2008
Impact of ramipril on the incidence of atrial fibrillation: results of the Heart Outcomes Prevention Evaluation study.
    American heart journal, 2007, Volume: 154, Issue:3

    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.. 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.. 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, > or = 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.. 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).. Although the incidence of AF was low, treatment with ramipril in this population without known LV systolic dysfunction did not significantly reduce this dysrhythmia.

    Topics: Aged; Angiotensin-Converting Enzyme Inhibitors; Atrial Fibrillation; Female; Follow-Up Studies; Humans; Incidence; Male; Ramipril

2007

Other Studies

7 other study(ies) available for ramipril and Atrial-Fibrillation

ArticleYear
Risk of renal dysfunction in an elderly patient with chronic heart failure.
    Medizinische Monatsschrift fur Pharmazeuten, 2016, Volume: 39, Issue:10

    The treatment of elderly multimorbid patients according to clinical guidelines often results in polypharmacy. An individual risk assessment is required to consider the possibility of deprescribing especially potentially inappropriate medication in the elderly. This exemplary case report describes a medication review of a patient with multiple chronic cardiovascular diseases taking into account the impact on renal function.

    Topics: Aged, 80 and over; Atrial Fibrillation; Carbazoles; Carvedilol; Diclofenac; Digoxin; Drug Interactions; Drug Therapy, Combination; Female; Heart Failure; Humans; Hypertension; Kidney Failure, Chronic; Myocardial Infarction; Potassium; Potentially Inappropriate Medication List; Propanolamines; Ramipril; Risk Factors; Spironolactone

2016
Prediction and prevention of atrial fibrillation in patients with high blood pressure or history of hypertension.
    Journal of hypertension, 2012, Volume: 30, Issue:5

    Topics: Atrial Fibrillation; Benzimidazoles; Benzoates; Cardiovascular Diseases; Female; Humans; Male; Ramipril; Telmisartan

2012
Precardiac surgery angiotensin-converting enzymes and mineralocorticoid blockers do not trump atrial fibrillation but possibly acute kidney injury: the value of a negative randomized study.
    Critical care medicine, 2012, Volume: 40, Issue:10

    Topics: Angiotensin-Converting Enzyme Inhibitors; Atrial Fibrillation; Cardiac Surgical Procedures; Female; Humans; Male; Ramipril; Receptors, Mineralocorticoid; Spironolactone

2012
Effect of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers on the frequency of post-cardiothoracic surgery atrial fibrillation.
    The Annals of pharmacotherapy, 2007, Volume: 41, Issue:3

    A recent meta-analysis demonstrated that angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) reduce the incidence of new-onset atrial fibrillation by nearly 50%. However, the ability of ACE inhibitors or ARBs to prevent post-cardiothoracic surgery (CTS) atrial fibrillation, when used postoperatively, has yet to be evaluated.. To evaluate the impact of postoperative ACE inhibitor or ARB use on the incidence of post-CTS atrial fibrillation.. We performed a retrospective cohort study of propensity score matched patients who underwent CTS at a single institution from January 2004 through December 2005. Patients who received either an ACE inhibitor or an ARB within 24 hours of surgery were propensity score matched for common predictors of post-CTS atrial fibrillation (age >70 y, preoperative digoxin use, postoperative beta-blocker or amiodarone use, beta-blocker intolerance, valve surgery, male sex, and history of diabetes mellitus, smoking, chronic obstructive pulmonary disease, prior cardiothoracic surgery) in a 1:1 ratio with patients who did not receive an ACE inhibitor or an ARB. Multivariate logistic regression was used to generate adjusted odds ratios to minimize the impact of baseline confounders.. A total of 1469 patients underwent CTS during the study evaluation period. Postoperatively, 188 received an ACE inhibitor or an ARB and were matched to 188 control patients. Mean +/- SD age of matched patients was 68.1 +/- 11.8 years, 66% were men, 42% underwent valve surgery, and 69% and 35% received postoperative beta-blockade and amiodarone, respectively. Patients who received an ACE inhibitor or an ARB did not experience a significant reduction in post-CTS atrial fibrillation compared with control patients (adjusted OR 0.95; 95% CI 0.57 to 1.56; p = 0.83).. In this evaluation, postoperative ACE inhibitor or ARB use was not associated with a reduction in post-CTS atrial fibrillation. A study of preoperative, longer-term ACE inhibitor and/or ARB therapy is needed to determine the benefits of that strategy.

    Topics: Aged; Aged, 80 and over; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Atrial Fibrillation; Biphenyl Compounds; Cardiac Surgical Procedures; Cohort Studies; Female; Humans; Irbesartan; Lisinopril; Male; Postoperative Complications; Ramipril; Retrospective Studies; Tetrazoles; Valine; Valsartan

2007
[Arrhythmogenic dilated cardiomyopathy].
    Medicina (Kaunas, Lithuania), 2003, Volume: 39, Issue:7

    Sustained or chronic tachyarrhythmia can produce reversible changes of atria or/and ventricles that induce systolic or/and diastolic disfunction, dilatation of heart chambers and progressive symptoms of heart failure. The changes regress after restoration of sinus rhythm. This is the clinical case, when at the beginning of the treatment, primary dilated cardiomyopathy is diagnosed to the patient having chronic atrial fibrillation and later after restoration of sinus rhythm and subsequent reduction of heart chambers as well as improvement of systolic function, past changes was assessed as reversible arrhythmogenic cardiomyopathy.

    Topics: Adult; Amiodarone; Angiotensin-Converting Enzyme Inhibitors; Anti-Arrhythmia Agents; Anticoagulants; Antihypertensive Agents; Atrial Fibrillation; Cardiomyopathy, Dilated; Echocardiography; Electric Countershock; Electrocardiography; Follow-Up Studies; Humans; Male; Ramipril; Time Factors; Warfarin

2003
Angiotensin-converting enzyme inhibitors and stroke prevention: what about the influence of atrial fibrillation and antithrombotic therapy?
    Stroke, 2003, Volume: 34, Issue:11

    Topics: Angiotensin-Converting Enzyme Inhibitors; Atenolol; Atrial Fibrillation; Clinical Trials as Topic; Fibrinolytic Agents; Humans; Losartan; Ramipril; Stroke

2003
Management of heart failure.
    Current cardiology reports, 2000, Volume: 2, Issue:3

    Topics: Angiotensin-Converting Enzyme Inhibitors; Anti-Arrhythmia Agents; Atrial Fibrillation; Coronary Disease; Heart Failure; Humans; Myocardial Revascularization; Phenethylamines; Ramipril; Randomized Controlled Trials as Topic; Sulfonamides; Ventricular Dysfunction, Left

2000
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