DATE : 21-06-10 12:31
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Comparison Between Beta-Blockers with Angiotensin-Converting Enzyme Inhibitors and Beta-Blockers with Angiotensin II Type I Receptor Blockers in ST-Segment Elevation Myocardial Infarction After Successful Percutaneous Coronary Intervention with Drug-Eluti
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WRITER :
stent
 HIT : 3,454
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 C227.+Comparison+Between+Beta-Blockers+with+Angiotensin-Converting+Enzyme+I~.pdf (1,020.3K) [0] DATE : 2021-06-10 12:31:10 |
Comparison Between Beta-Blockers with Angiotensin-Converting Enzyme Inhibitors and Beta-Blockers with Angiotensin II Type I Receptor Blockers in ST-Segment Elevation Myocardial Infarction After Successful Percutaneous Coronary Intervention with Drug-Eluti
Yong Hoon Kim, Ae-Young Her,Myung Ho Jeong,Byeong-Keuk Kim,Seung-Yul Lee,Sung-Jin Hong,Dong-Ho Shin,Jung-Sun Kim,Young-Guk Ko,Donghoon Choi,Myeong-Ki Hong,Yangsoo Jang
Cardiovasc Drugs Ther
Abstract
Background/Aims Limited comparative data concerning long-term clinical outcomes of combination therapy between betablockers (BB) with angiotensin-converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) therapy in patients with ST-segment elevation myocardial infarction (STEMI) are available. We thought to compare 2-year major clinical outcomes between BB with ACEI and BB with ARB therapy in patients with STEMI after successful percutaneous coronary intervention (PCI) with drug-eluting stents (DES).
Methods 13,873 STEMI patients who underwent successful PCI with DES were enrolled and divided into two groups as the BB
with ACEI group (n = 10,393) and the BB with ARB group (n = 3480). The clinical endpoint was the occurrence of major
adverse cardiac events (MACE) defined as all-cause death, cardiac death (CD), recurrent myocardial infarction (re-MI), total
coronary revascularization (target lesion revascularization [TLR], target vessel revascularization [TVR], non-TVR) during the 2-
year follow-up period.
Results After propensity score-matched (PSM) analysis, two PSM groups (3296 pairs, n = 6592, C-statistic = 0.675) were generated. Although the incidences of re-MI, TLR, and TVR were similar, the incidences of MACE (8.3% vs. 6.8%, log-rank p = 0.038, hazard ratio [HR] 1.210, 95% confidence interval [CI] 1.010–1.451, p = 0.039), all-cause death, CD, total revascularization, and non-TVR of the BB with ARB group were significantly higher than the BB with ACEI group after PSM. In addition, diabetes and multivessel disease were significant predictors for non-TVR. Conclusions The combination BB with ACEI may be beneficial for reducing MACE in STEMI patients after successful PCI with DES than the BB with ARB.
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