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The impact of angiotensin-converting-enzyme inhibitors versus angiotensin receptor blockers on 3-year clinical outcomes in elderly (≥ 65) patients with acute myocardial infarction without hypertension.
- Source :
-
Heart & Vessels . Jul2023, Vol. 38 Issue 7, p898-908. 11p. - Publication Year :
- 2023
-
Abstract
- Objective: This study aimed to investigate the impact of angiotensin-converting-enzyme inhibitors (ACEI) and angiotensin II type 1 receptor blockers (ARB) on 3-year clinical outcomes in elderly (≥ 65) acute myocardial infarction (AMI) patients without a history of hypertension who underwent successful percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: A total of 13,104 AMI patients who were registered in the Korea AMI registry (KAMIR)-National Institutes of Health (NIH) were included in the study. The primary endpoint was 3-year major adverse cardiac events (MACE), which was defined as the composite of all-cause death, recurrent myocardial infarction (MI), and any repeat revascularization. To adjust baseline potential confounders, an inverse probability weighting (IPTW) analysis was performed. Results: The patients were divided into two groups: the ACEI group, n = 872 patients and the ARB group, n = 508 patients. After IPTW matching, baseline characteristics were balanced. During the 3-year clinical follow-up, the incidence of MACE was not different between the two groups. However, incidence of stroke (hazard ratio [HR], 0.375; 95% confidence interval [CI], 0.166–0.846; p = 0.018) and re-hospitalization due to heart failure (HF) (HR, 0.528; 95% CI, 0.289–0.965; p = 0.038) in the ACEI group were significantly lower than in the ARB group. Conclusion: In elderly AMI patients who underwent PCI with DES without a history of hypertension, the use of ACEI was significantly associated with reduced incidences of stroke, and re-hospitalization due to HF than those with the use of ARB. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 09108327
- Volume :
- 38
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- Heart & Vessels
- Publication Type :
- Academic Journal
- Accession number :
- 163887179
- Full Text :
- https://doi.org/10.1007/s00380-023-02244-x