Author(s) |
(a) The Acute Infarction Ramipril Efficacy (AIRE) study investigators
(b) Ball SG, Hall AS, Murray GD
(c) Cleland JGF, Erhardt L, Murray G, Hall AS, Ball SG
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Title(s) |
(a) Effect of ramipril on mortality and morbidity of survivors of acute myocardial infarction with clinical evidence of heart failure
(b) ACE inhibition, atherosclerosis and myocardial infarction - the AIRE study
(c) Effect of ramipril on morbidity and mode of death among survivors of acute myocardial infarction with clinical evidence of heart failure. A report from the AIRE study investigators
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Reference(s) |
(a) Lancet 1993;342:821-8
(b) Eur Heart J 1994;15 Suppl B:20-5
(c) Eur Heart J 1997;18:41-51
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Disease |
AMI with heart failure
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Purpose |
To compare the effects of ramipril to placebo on total mortality in patients surviving AMI and with early clinical evidence of heart failure. Secondary, to compare the incidences of progression to severe or resistant heart failure, nonfatal reinfarction and stroke between the 2 groups
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Study design |
Randomised, double-blind, placebo-controlled, parallel-group
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Follow-up |
More than 6 months with an average of 15 months
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Patients |
2006 patients (1014 ramipril, 992 placebo), aged ≥ 18 years, with a definite AMI 3-10 days before randomisation and clinical evidence of heart failure at any time since AMI. Patients with severe or resistant heart failure were excluded
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Treatment regimen |
Ramipril, 2.5-5 mg bid, or placebo
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Results |
Mortality from all causes was significantly lower for patients on ramipril compared to patients on placebo. The risk reduction was 27% (p = 0.002). Ramipril reduced the risk of sudden death by 30% (p = 0.011) and of death from circulatory failure by 18% (p = 0.237). The magnitude of the effects on sudden death and death due to circulatory failure were not significantly different, but 38% of the reduction in overall mortality was from the subgroup with sudden death who had developed prior severe resistant heart failure. The mortality reduction was already apparent at 30 days and consistent across a range of subgroups. Ramipril did not alter the rate of stroke or reinfarction
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Comments |
The study continued into the AIREX study
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