title: Effects of an angiotensin-converting enzyme inhibitor (ramipril) on inflammatory markers in secondary prevention patients: RAICES Study.
abstract: OBJECTIVE
  To evaluate the hypothesis that angiotensin-converting enzyme inhibitor therapy with ramipril reduces baseline levels of C-reactive protein in patients at high cardiovascular risk.
  
  
  METHODS
  Secondary 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.
  
  
  RESULTS
  A 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 levels: low-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.
  
  
  CONCLUSIONS
  Highly 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.
authors.affiliation: PROCORDIS, Fundación Bioquímica Argentina, La Plata, Argentina. procordis@fba.org.ar
authors.forename: Ricardo G
authors.initials: RG
authors.lastname: Lopez Santi
authors.forename: Eduardo C
authors.initials: EC
authors.lastname: Valeff
authors.forename: Claudio R
authors.initials: CR
authors.lastname: Duymovich
authors.forename: Daniel
authors.initials: D
authors.lastname: Mazziotta
authors.forename: Norma E
authors.initials: NE
authors.lastname: Mijailovsky
authors.forename: Gerardo C
authors.initials: GC
authors.lastname: Filippa
authors.forename: Raúl
authors.initials: R
authors.lastname: Maltez
authors.forename: Violeta A
authors.initials: VA
authors.lastname: Hernandez
authors.forename: Alejandro Gomez
authors.initials: AG
authors.lastname: Monroy
authors.forename: Jorge G
authors.initials: JG
authors.lastname: Borzi
authors.forename: Rosana A
authors.initials: RA
authors.lastname: Acheme
authors.forename: María C
authors.initials: MC
authors.lastname: Etchegoyen
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology*; D002097:C-Reactive Protein / Q000032:analysis / Q000187:drug effects*; D002318:Cardiovascular Diseases / Q000517:prevention & control*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007249:Inflammation / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D017257:Ramipril / Q000494:pharmacology*; D012307:Risk Factors; D055502:Secondary Prevention
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D002097:C-Reactive Protein; D017257:Ramipril