In Suck Choi1,2, Ie Byung Park1,2, Kiyoung Lee1,2, Tae Hoon Ahn1,2, Ju Han Kim3, Youngkeun Ahn3, Sung-Chull Chae4, Hyo-Soo Kim5, Young Jo Kim6, Myeong Chan Cho7, Chong Jin Kim8, Myung Ho Jeong3, Dae Ho Lee1,2. 1. 1 Department of Internal Medicine, Gachon University College of Medicine, Incheon, Republic of Korea. 2. 2 Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea. 3. 3 Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea. 4. 4 Kyungpook National University Hospital, School of Medicine, Daegu, Republic of Korea. 5. 5 Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. 6. 6 Department of Internal Medicine, Yeungnam University Hospital, Daegu, Republic of Korea. 7. 7 Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Republic of Korea. 8. 8 Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Republic of Korea.
Abstract
AIM: Renin-angiotensin-aldosterone system inhibitors (RASIs) are widely used in high-risk cardiovascular (CV) diseases, including acute myocardial infarction (AMI). However, it is not yet clear which class of RASIs provides specific benefits to patients with AMI. The present study aimed to evaluate whether angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs) had any different effects on long-term CV and all-cause mortality in patients with AMI who received either agent from admission and were discharged alive from the hospital. METHODS: We analyzed data of patients with AMI from the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry. Cardiovascular and all-cause mortality at 12 months after AMI were assessed. RESULTS: Among 12 481 patients with AMI who were discharged alive, RASI treatment was as follows: ACEIs (n = 5910), ARBs (n = 4009), and no RASI (n = 2562). After adjustment for multiple factors, compared with no RASI therapy, ACEI therapy was associated with lower hazard ratios (HRs) for 1-year CV and total mortality rates, whereas ARB therapy was not. In a direct comparison, compared with ARB treatment, ACEI treatment was associated with lower HRs (95% confidence interval) for CV and total mortality: 0.562 (0.420-0.753) and 0.567 (0.451-0.713), respectively. The superiority of ACEI to ARB was also observed across several subgroups. The mortality differences between the 2 treatment groups were reproduced in a propensity-score matched analysis (n = 2855 each). CONCLUSIONS: Our study of a recent AMI registry data revealed that ACEI therapy in patients with AMI was associated with better long-term survival benefits than ARB therapy.
AIM: Renin-angiotensin-aldosterone system inhibitors (RASIs) are widely used in high-risk cardiovascular (CV) diseases, including acute myocardial infarction (AMI). However, it is not yet clear which class of RASIs provides specific benefits to patients with AMI. The present study aimed to evaluate whether angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs) had any different effects on long-term CV and all-cause mortality in patients with AMI who received either agent from admission and were discharged alive from the hospital. METHODS: We analyzed data of patients with AMI from the Korea Acute Myocardial Infarction Registry-National Institutes of Health registry. Cardiovascular and all-cause mortality at 12 months after AMI were assessed. RESULTS: Among 12 481 patients with AMI who were discharged alive, RASI treatment was as follows: ACEIs (n = 5910), ARBs (n = 4009), and no RASI (n = 2562). After adjustment for multiple factors, compared with no RASI therapy, ACEI therapy was associated with lower hazard ratios (HRs) for 1-year CV and total mortality rates, whereas ARB therapy was not. In a direct comparison, compared with ARB treatment, ACEI treatment was associated with lower HRs (95% confidence interval) for CV and total mortality: 0.562 (0.420-0.753) and 0.567 (0.451-0.713), respectively. The superiority of ACEI to ARB was also observed across several subgroups. The mortality differences between the 2 treatment groups were reproduced in a propensity-score matched analysis (n = 2855 each). CONCLUSIONS: Our study of a recent AMI registry data revealed that ACEI therapy in patients with AMI was associated with better long-term survival benefits than ARB therapy.
Authors: Sungmin Lim; Eun Ho Choo; Ik Jun Choi; Sang Hyun Ihm; Hee Yeol Kim; Youngkeun Ahn; Kiyuk Chang; Myung Ho Jeong; Ki Bae Seung Journal: J Korean Med Sci Date: 2019-11-25 Impact factor: 2.153
Authors: Gwang Sil Kim; Young Guk Ko; Yongsung Suh; Hoyoun Won; Sung Jin Hong; Chul Min Ahn; Jung Sun Kim; Byeong Keuk Kim; Donghoon Choi; Myeong Ki Hong; Yangsoo Jang Journal: Korean Circ J Date: 2020-07-13 Impact factor: 3.243