Author + information
- Marie Mide Michelsen,
- Anna Bay Rask,
- Elena Suhrs,
- Naja Mygind,
- Nis Host and
- Eva Prescott
Background: The renin-angiotensin system may be involved in coronary microvascular dysfunction (CMD). We investigated whether the angiotensin-converting enzyme inhibitor, ramipril, improved coronary microvascular function and symptoms in normotensive women with angina and CMD.
Method: We included 65 women with angina pectoris, no epicardial vessel stenosis >50%, blood pressure<150 mmHg and CMD defined as a coronary flow velocity reserve (CFVR)<2.5. Patients were randomized 1:1 in double-blinded manner to placebo or ramipril (maximum 10 mg) for minimum 4 months. Primary outcome was CFVR assessed by echocardiography during adenosine infusion. Symptom burden was evaluated by the Seattle Angina Questionnaire. (clinicaltrials.gov, NCT02525081, and ethically approved).
Results: A total of 55 patients completed the study (ramipril group, 28, and placebo, 27). Monthly self-reported compliance was high. Blood pressure remained unchanged in both groups. CFVR improved significantly in both the ramipril and placebo group (p=0.008 and p=0.02, respectively) with no significant difference in effect between groups (p=0.31). Also symptoms improved in both groups with no differences between groups (Table).
Conclusions: Contrary to previous studies, treatment with ramipril had no significant effect on CFVR or symptoms compared with placebo in normotensive women with angina and CMD. However, previous studies were small, of varying quality and the effect could be mediated through blood pressure reduction.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Vascular Medicine: Novel Risk Measures in Arterial Diseases
Abstract Category: 40. Vascular Medicine: Non Coronary Arterial Disease
Presentation Number: 1167-352
- 2017 American College of Cardiology Foundation