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ACE Inhibitors Versus ARBs in Patients With NSTEMI With Preserved LV Systolic Function Who Underwent PCI With New Generation Drug-Eluting Stents

Authors
 Yong Hoon Kim  ;  Ae-Young Her  ;  Myung Ho Jeong  ;  Byeong-Keuk Kim  ;  Sung-Jin Hong  ;  Seunghwan Kim  ;  Chul-Min Ahn  ;  Jung-Sun Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Yangsoo Jang 
Citation
 ANGIOLOGY, Vol.71(2) : 139-149, 2020-02 
Journal Title
ANGIOLOGY
ISSN
 0003-3197 
Issue Date
2020-02
MeSH
Aged ; Angiotensin Receptor Antagonists / therapeutic use* ; Angiotensin-Converting Enzyme Inhibitors / therapeutic use* ; Drug-Eluting Stents* ; Female ; Humans ; Male ; Middle Aged ; Non-ST Elevated Myocardial Infarction / surgery* ; Percutaneous Coronary Intervention* ; Postoperative Complications / epidemiology* ; Postoperative Complications / prevention & control* ; Retrospective Studies ; Systole / physiology ; Ventricular Function, Left / physiology
Keywords
non-ST-segment elevation myocardial infarction ; renin-angiotensin system ; outcomes
Abstract
The relative superiority of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on long-term clinical outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI) with preserved left ventricular systolic function in the era of new generation drug-eluting stents is not well established. A total of 6436 patients with NSTEMI (ACEIs group: n = 3965 vs ARBs group: n = 2471) were enrolled. The major clinical end point was the occurrences of major adverse cardiac events (MACEs), defined as all-cause death, recurrent myocardial infarction (re-MI), and any repeat revascularization. After propensity score matching analysis, the cumulative incidences of MACEs (hazard ratio, 1.334; 95% confidence interval, 1.045-1.703; P = .021), any repeat revascularization, and target vessel revascularization (TVR) in the ARB group were significantly higher than that in the ACEI group. However, the cumulative incidences of all-cause death, cardiac death, re-MI, target lesion revascularization, and non-TVR were similar between the 2 groups. Hence, although the mortality and re-MI reduction benefits were similar between the 2 groups, the ACEIs group showed more prominent ability to decrease the occurrences of MACEs, any repeat revascularization, and TVR compared to the ARBs group in these patients during a 2-year follow-up period.
Full Text
https://journals.sagepub.com/doi/10.1177/0003319719884187
DOI
10.1177/0003319719884187
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190241
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