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- Title
Clinical Outcomes at 2 Years Between Beta-Blockade with ACE Inhibitors or ARBs in Patients with AMI Who Underwent Successful PCI with DES: A Retrospective Analysis of 23,978 Patients in the Korea AMI Registry.
- Authors
Kim, Yong Hoon; Her, Ae-Young; Jeong, Myung Ho; Kim, Byeong-Keuk; Hong, Sung-Jin; Shin, Dong-Ho; Kim, Jung-Sun; Ko, Young-Guk; Choi, Donghoon; Hong, Myeong-Ki; Jang, Yangsoo
- Abstract
Introduction: Data concerning the clinical impact of combination therapy with β-blockers (BBs) + angiotensin-converting enzyme inhibitors (ACEIs) compared with BBs + angiotensin-receptor blockers (ARBs) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) are limited. Objective: We compared the clinical outcomes at 2 years between these two combination therapies. Methods: We enrolled 23,978 patients with AMI who underwent successful PCI with DES between January 2005 and June 2015 from the Korea AMI Registry (KAMIR) and divided them into the two groups: BB + ACEI (n = 17,310) and BB + ARB (n = 6668). The primary endpoint was major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (re-MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and non-TVR. The secondary endpoints were the cumulative incidences of individual components of MACE and target vessel failure (TVF), a composite of death related to the target vessel, re-MI, or clinically driven TVR. Results: The relative risk of MACE was higher in the BB + ARB group than in the BB + ACEI group after propensity score-matched (PSM) analysis (hazard ratio [HR] 1.204; 95% confidence interval [CI] 1.057–1.370; p = 0.005). The relative risks of all-cause death (HR 1.435 [95% CI 1.117–1.845]; p = 0.005), cardiac death (HR 1.733 [95% CI 1.253–2.396]; p = 0.001), TVR (HR 1.437 [95% CI 1.157–1.784]; p = 0.001), and TVF (HR 1.231 [95% CI 1.065–1.424]; p = 0.005) were also higher in the BB + ARB group after PSM. Conclusions: The BB + ACEI group demonstrated reduced cumulative incidences of MACE, all-cause death, cardiac death, TVR, and TVF compared with the BB + ARB group in patients with AMI who underwent successful PCI with DES during a 2-year follow-up period.
- Subjects
SOUTH Korea; ADRENERGIC beta blockers; ACE inhibitors; ADVERSE health care events; ANGIOTENSIN receptors; COMBINATION drug therapy; COMPARATIVE studies; CONFIDENCE intervals; DEATH; REPORTING of diseases; MYOCARDIAL infarction; MYOCARDIAL revascularization; TIME; DISEASE relapse; RELATIVE medical risk; TREATMENT effectiveness; RETROSPECTIVE studies; ACUTE diseases; DRUG-eluting stents; DESCRIPTIVE statistics; PERCUTANEOUS coronary intervention; EVALUATION; THERAPEUTICS
- Publication
American Journal of Cardiovascular Drugs, 2019, Vol 19, Issue 4, p403
- ISSN
1175-3277
- Publication type
Article
- DOI
10.1007/s40256-019-00326-8