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- Title
The impact of angiotensin-converting-enzyme inhibitors versus angiotensin receptor blockers on 3-year clinical outcomes in elderly (≥ 65) patients with acute myocardial infarction without hypertension.
- Authors
Ahn, Woo Jin; Rha, Seung-Woon; Choi, Byoung Geol; Jeong, Myung Ho; Ahn, Tae Hoon; Yoon, Junghan; Kim, Hyo‐Soo; Seung, Ki‐Bae; Gwon, Hyeon‐Cheol; Chae, Shung Chull; Kim, Chong‐Jin; Cha, Kwang Soo; Lee, Jung‐Hee; Chae, Jei Keon; Joo, Seung‐Jae; Yoon, Chang‐Hwan; Hur, Seung‐Ho; Seong, In‐Whan; Hwang, Kyung‐Kuk; Kim, Doo‐Il
- Abstract
Objective: This study aimed to investigate the impact of angiotensin-converting-enzyme inhibitors (ACEI) and angiotensin II type 1 receptor blockers (ARB) on 3-year clinical outcomes in elderly (≥ 65) acute myocardial infarction (AMI) patients without a history of hypertension who underwent successful percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: A total of 13,104 AMI patients who were registered in the Korea AMI registry (KAMIR)-National Institutes of Health (NIH) were included in the study. The primary endpoint was 3-year major adverse cardiac events (MACE), which was defined as the composite of all-cause death, recurrent myocardial infarction (MI), and any repeat revascularization. To adjust baseline potential confounders, an inverse probability weighting (IPTW) analysis was performed. Results: The patients were divided into two groups: the ACEI group, n = 872 patients and the ARB group, n = 508 patients. After IPTW matching, baseline characteristics were balanced. During the 3-year clinical follow-up, the incidence of MACE was not different between the two groups. However, incidence of stroke (hazard ratio [HR], 0.375; 95% confidence interval [CI], 0.166–0.846; p = 0.018) and re-hospitalization due to heart failure (HF) (HR, 0.528; 95% CI, 0.289–0.965; p = 0.038) in the ACEI group were significantly lower than in the ARB group. Conclusion: In elderly AMI patients who underwent PCI with DES without a history of hypertension, the use of ACEI was significantly associated with reduced incidences of stroke, and re-hospitalization due to HF than those with the use of ARB.
- Subjects
SOUTH Korea; ANGIOTENSIN-receptor blockers; AMERICAN Megatrends Inc.; NATIONAL Institutes of Health (U.S.); MYOCARDIAL infarction; MAJOR adverse cardiovascular events; OLDER patients; PERCUTANEOUS coronary intervention; OLDER people
- Publication
Heart & Vessels, 2023, Vol 38, Issue 7, p898
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-023-02244-x