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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.
- Source :
- American Journal of Cardiovascular Drugs; Aug2019, Vol. 19 Issue 4, p403-414, 12p
- Publication Year :
- 2019
-
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. [ABSTRACT FROM AUTHOR]
- Subjects :
- 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
Subjects
Details
- Language :
- English
- ISSN :
- 11753277
- Volume :
- 19
- Issue :
- 4
- Database :
- Complementary Index
- Journal :
- American Journal of Cardiovascular Drugs
- Publication Type :
- Academic Journal
- Accession number :
- 137147802
- Full Text :
- https://doi.org/10.1007/s40256-019-00326-8