DATE : 21-06-10 15:23
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Effect of renin-angiotensin system inhibitors on major clinical outcomes in patients with acute myocardial infarction and prediabetes or diabetes after successful implantation of newer-generation drug-eluting stents.
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WRITER :
stent
 HIT : 2,255
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Kim YH, Her AY, Jeong MH, Kim BK, Hong SJ, Kim S, Ahn CM, Kim JS, Ko YG, Choi D, Hong MK, Jang Y
Effect of renin-angiotensin system inhibitors on major clinical outcomes in patients with acute myocardial infarction and prediabetes or diabetes after successful implantation of newer-generation drug-eluting stents.
JOURNAL OF DIABETES AND ITS COMPLICATIONS
Aim: To investigate the comparative effectiveness of renin-angiotensin system inhibitor (RASI) therapy on major clinical outcomes in patients with acute myocardial infarction (AMI) and prediabetes or diabetes after successful percutaneous coronary intervention (PCI) with newer-generation drug-eluting stents (DESs).
Methods: A total of 11,962 patients with AMI were divided into six groups according to glycemic status and the presence or absence of RASI therapy: normoglycemia (n = 3,080; RASI- [n = 2,496], RASI- [n = 584]), prediabetes (n = 3,709; RASI- [n = 2,9441, RASI- [n = 765]), and diabetes (n = 5,173; RASI- [n = 4,1331, RASI- [n 1,040]). The major endpoint was major adverse cardiac events (MACEs), defined as all-cause death, recurrent myocardial infarction (re-MI), or any repeat revascularization.
Results: After adjustment, in RASI users, the cumulative incidence of re-MI of the diabetes group was significantly higher than that of the prediabetes group (aHR, 1.999; 95% CI, 1.153-3.467; p- 0.014). However, the cumulative incidences of MACEs, all-cause death, and any repeat revascularization were similar between the two groups during a 2-year follow-up period.
Conclusions: In the era of newer-generation DESs, RASI therapy did not reduce re-MI in patients with AMI and diabetes in this study. (C) 2020 Elsevier Inc. All rights reserved.
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