Clinical impacts of inhibition of renin–angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention

Hyukjin Park, Hyun Kuk Kim, Myung Ho Jeong, Jae Yeong Cho, Ki Hong Lee, Doo Sun Sim, Nam Sik Yoon, Hyun Ju Yoon, Young Joon Hong, Kye Hun Kim, Hyung Wook Park, Ju Han Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Young Jo Kim, Myeong Chan Cho, Chong Jim Kim, Myung Ho Jeong, Young Jo KimChong Jin Kim, Myeong Chan Cho, Young Keun Ahn, Jong Hyun Kim, Shung Chull Chae, Seung Ho Hur, In Whan Seong, Taek Jong Hong, Dong Hoon Choi, Jei Keon Chae, Jae Young Rhew, Doo Il Kim, In Ho Chae, Jung han Yoon, Bon Kwon Koo, Byung Ok Kim, Myoung Yong Lee, Kee Sik Kim, Jin Yong Hwang, Seok Kyu Oh, Nae Hee Lee, Kyoung Tae Jeong, Seung Jea Tahk, Jang Ho Bae, Seung Woon Rha, Keum Soo Park, Kyoo Rok Han, Tae Hoon Ahn, Moo Hyun Kim, Joo Young Yang, Chong Yun Rhim, Hyeon Cheol Gwon, Seong Wook Park, Young Youp Koh, Seung Jae Joo, Soo Joong Kim, Dong Kyu Jin, Jin Man Cho, Wook Sung Chung, Yang Soo Jang, Jeong Gwan Cho, Ki Bae Seung, Seung Jung Park

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Successful percutaneous coronary intervention (PCI) of the occluded infarct-related artery (IRA) in latecomers may improve long-term survival mainly by reducing left ventricular remodeling. It is not clear whether inhibition of renin–angiotensin system (RAS) brings additional better clinical outcomes in this specific population subset. Methods Between January 2008 and June 2013, 669 latecomer patients with acute ST-segment elevation myocardial infarction (STEMI) (66.2 ± 12.1 years, 71.0% males) in Korea Acute Myocardial Infarction Registry (KAMIR) who underwent a successful PCI were enrolled. The study population underwent a successful PCI for a totally occluded IRA. They were divided into two groups according to whether they were prescribed RAS inhibitors at the time of discharge: group I (RAS inhibition, n = 556), and group II (no RAS inhibition, n = 113). Results During the one-year follow-up, major adverse cardiac events (MACE), which consist of cardiac death and myocardial infarction, occurred in 71 patients (10.6%). There were significantly reduced incidences of MACE in the group I (hazard ratio = 0.34, 95% confidence interval 0.199–0.588, p = 0.001). In subgroup analyses, RAS inhibition was beneficial in patients with male gender, history of hypertension or diabetes mellitus, and even in patients with left ventricular ejection fraction (LVEF) ≥40%. In the baseline and follow-up echocardiographic data, benefit in changes of LVEF and left ventricular end-systolic volume was noted in group I. Conclusions In latecomers with STEMI, RAS inhibition improved long-term clinical outcomes after a successful PCI, even in patients with low risk who had relatively preserved LVEF.

Original languageEnglish
Pages (from-to)216-221
Number of pages6
JournalJournal of Cardiology
Volume69
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

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Percutaneous Coronary Intervention
Stroke Volume
Myocardial Infarction
Arteries
Ventricular Remodeling
Korea
Population
Registries
Diabetes Mellitus
ST Elevation Myocardial Infarction
Confidence Intervals
Hypertension
Survival
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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Park, Hyukjin ; Kim, Hyun Kuk ; Jeong, Myung Ho ; Cho, Jae Yeong ; Lee, Ki Hong ; Sim, Doo Sun ; Yoon, Nam Sik ; Yoon, Hyun Ju ; Hong, Young Joon ; Kim, Kye Hun ; Park, Hyung Wook ; Kim, Ju Han ; Ahn, Youngkeun ; Cho, Jeong Gwan ; Park, Jong Chun ; Kim, Young Jo ; Cho, Myeong Chan ; Kim, Chong Jim ; Jeong, Myung Ho ; Kim, Young Jo ; Kim, Chong Jin ; Cho, Myeong Chan ; Ahn, Young Keun ; Kim, Jong Hyun ; Chae, Shung Chull ; Hur, Seung Ho ; Seong, In Whan ; Hong, Taek Jong ; Choi, Dong Hoon ; Chae, Jei Keon ; Rhew, Jae Young ; Kim, Doo Il ; Chae, In Ho ; Yoon, Jung han ; Koo, Bon Kwon ; Kim, Byung Ok ; Lee, Myoung Yong ; Kim, Kee Sik ; Hwang, Jin Yong ; Oh, Seok Kyu ; Lee, Nae Hee ; Jeong, Kyoung Tae ; Tahk, Seung Jea ; Bae, Jang Ho ; Rha, Seung Woon ; Park, Keum Soo ; Han, Kyoo Rok ; Ahn, Tae Hoon ; Kim, Moo Hyun ; Yang, Joo Young ; Rhim, Chong Yun ; Gwon, Hyeon Cheol ; Park, Seong Wook ; Koh, Young Youp ; Joo, Seung Jae ; Kim, Soo Joong ; Jin, Dong Kyu ; Cho, Jin Man ; Chung, Wook Sung ; Jang, Yang Soo ; Cho, Jeong Gwan ; Seung, Ki Bae ; Park, Seung Jung. / Clinical impacts of inhibition of renin–angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention. In: Journal of Cardiology. 2017 ; Vol. 69, No. 1. pp. 216-221.
@article{f6d6487e6b994429a68dfb3ff2ff5fc6,
title = "Clinical impacts of inhibition of renin–angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention",
abstract = "Background Successful percutaneous coronary intervention (PCI) of the occluded infarct-related artery (IRA) in latecomers may improve long-term survival mainly by reducing left ventricular remodeling. It is not clear whether inhibition of renin–angiotensin system (RAS) brings additional better clinical outcomes in this specific population subset. Methods Between January 2008 and June 2013, 669 latecomer patients with acute ST-segment elevation myocardial infarction (STEMI) (66.2 ± 12.1 years, 71.0{\%} males) in Korea Acute Myocardial Infarction Registry (KAMIR) who underwent a successful PCI were enrolled. The study population underwent a successful PCI for a totally occluded IRA. They were divided into two groups according to whether they were prescribed RAS inhibitors at the time of discharge: group I (RAS inhibition, n = 556), and group II (no RAS inhibition, n = 113). Results During the one-year follow-up, major adverse cardiac events (MACE), which consist of cardiac death and myocardial infarction, occurred in 71 patients (10.6{\%}). There were significantly reduced incidences of MACE in the group I (hazard ratio = 0.34, 95{\%} confidence interval 0.199–0.588, p = 0.001). In subgroup analyses, RAS inhibition was beneficial in patients with male gender, history of hypertension or diabetes mellitus, and even in patients with left ventricular ejection fraction (LVEF) ≥40{\%}. In the baseline and follow-up echocardiographic data, benefit in changes of LVEF and left ventricular end-systolic volume was noted in group I. Conclusions In latecomers with STEMI, RAS inhibition improved long-term clinical outcomes after a successful PCI, even in patients with low risk who had relatively preserved LVEF.",
author = "Hyukjin Park and Kim, {Hyun Kuk} and Jeong, {Myung Ho} and Cho, {Jae Yeong} and Lee, {Ki Hong} and Sim, {Doo Sun} and Yoon, {Nam Sik} and Yoon, {Hyun Ju} and Hong, {Young Joon} and Kim, {Kye Hun} and Park, {Hyung Wook} and Kim, {Ju Han} and Youngkeun Ahn and Cho, {Jeong Gwan} and Park, {Jong Chun} and Kim, {Young Jo} and Cho, {Myeong Chan} and Kim, {Chong Jim} and Jeong, {Myung Ho} and Kim, {Young Jo} and Kim, {Chong Jin} and Cho, {Myeong Chan} and Ahn, {Young Keun} and Kim, {Jong Hyun} and Chae, {Shung Chull} and Hur, {Seung Ho} and Seong, {In Whan} and Hong, {Taek Jong} and Choi, {Dong Hoon} and Chae, {Jei Keon} and Rhew, {Jae Young} and Kim, {Doo Il} and Chae, {In Ho} and Yoon, {Jung han} and Koo, {Bon Kwon} and Kim, {Byung Ok} and Lee, {Myoung Yong} and Kim, {Kee Sik} and Hwang, {Jin Yong} and Oh, {Seok Kyu} and Lee, {Nae Hee} and Jeong, {Kyoung Tae} and Tahk, {Seung Jea} and Bae, {Jang Ho} and Rha, {Seung Woon} and Park, {Keum Soo} and Han, {Kyoo Rok} and Ahn, {Tae Hoon} and Kim, {Moo Hyun} and Yang, {Joo Young} and Rhim, {Chong Yun} and Gwon, {Hyeon Cheol} and Park, {Seong Wook} and Koh, {Young Youp} and Joo, {Seung Jae} and Kim, {Soo Joong} and Jin, {Dong Kyu} and Cho, {Jin Man} and Chung, {Wook Sung} and Jang, {Yang Soo} and Cho, {Jeong Gwan} and Seung, {Ki Bae} and Park, {Seung Jung}",
year = "2017",
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doi = "10.1016/j.jjcc.2016.03.012",
language = "English",
volume = "69",
pages = "216--221",
journal = "Journal of Cardiology",
issn = "0914-5087",
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Park, H, Kim, HK, Jeong, MH, Cho, JY, Lee, KH, Sim, DS, Yoon, NS, Yoon, HJ, Hong, YJ, Kim, KH, Park, HW, Kim, JH, Ahn, Y, Cho, JG, Park, JC, Kim, YJ, Cho, MC, Kim, CJ, Jeong, MH, Kim, YJ, Kim, CJ, Cho, MC, Ahn, YK, Kim, JH, Chae, SC, Hur, SH, Seong, IW, Hong, TJ, Choi, DH, Chae, JK, Rhew, JY, Kim, DI, Chae, IH, Yoon, JH, Koo, BK, Kim, BO, Lee, MY, Kim, KS, Hwang, JY, Oh, SK, Lee, NH, Jeong, KT, Tahk, SJ, Bae, JH, Rha, SW, Park, KS, Han, KR, Ahn, TH, Kim, MH, Yang, JY, Rhim, CY, Gwon, HC, Park, SW, Koh, YY, Joo, SJ, Kim, SJ, Jin, DK, Cho, JM, Chung, WS, Jang, YS, Cho, JG, Seung, KB & Park, SJ 2017, 'Clinical impacts of inhibition of renin–angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention', Journal of Cardiology, vol. 69, no. 1, pp. 216-221. https://doi.org/10.1016/j.jjcc.2016.03.012

Clinical impacts of inhibition of renin–angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention. / Park, Hyukjin; Kim, Hyun Kuk; Jeong, Myung Ho; Cho, Jae Yeong; Lee, Ki Hong; Sim, Doo Sun; Yoon, Nam Sik; Yoon, Hyun Ju; Hong, Young Joon; Kim, Kye Hun; Park, Hyung Wook; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun; Kim, Young Jo; Cho, Myeong Chan; Kim, Chong Jim; Jeong, Myung Ho; Kim, Young Jo; Kim, Chong Jin; Cho, Myeong Chan; Ahn, Young Keun; Kim, Jong Hyun; Chae, Shung Chull; Hur, Seung Ho; Seong, In Whan; Hong, Taek Jong; Choi, Dong Hoon; Chae, Jei Keon; Rhew, Jae Young; Kim, Doo Il; Chae, In Ho; Yoon, Jung han; Koo, Bon Kwon; Kim, Byung Ok; Lee, Myoung Yong; Kim, Kee Sik; Hwang, Jin Yong; Oh, Seok Kyu; Lee, Nae Hee; Jeong, Kyoung Tae; Tahk, Seung Jea; Bae, Jang Ho; Rha, Seung Woon; Park, Keum Soo; Han, Kyoo Rok; Ahn, Tae Hoon; Kim, Moo Hyun; Yang, Joo Young; Rhim, Chong Yun; Gwon, Hyeon Cheol; Park, Seong Wook; Koh, Young Youp; Joo, Seung Jae; Kim, Soo Joong; Jin, Dong Kyu; Cho, Jin Man; Chung, Wook Sung; Jang, Yang Soo; Cho, Jeong Gwan; Seung, Ki Bae; Park, Seung Jung.

In: Journal of Cardiology, Vol. 69, No. 1, 01.01.2017, p. 216-221.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical impacts of inhibition of renin–angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention

AU - Park, Hyukjin

AU - Kim, Hyun Kuk

AU - Jeong, Myung Ho

AU - Cho, Jae Yeong

AU - Lee, Ki Hong

AU - Sim, Doo Sun

AU - Yoon, Nam Sik

AU - Yoon, Hyun Ju

AU - Hong, Young Joon

AU - Kim, Kye Hun

AU - Park, Hyung Wook

AU - Kim, Ju Han

AU - Ahn, Youngkeun

AU - Cho, Jeong Gwan

AU - Park, Jong Chun

AU - Kim, Young Jo

AU - Cho, Myeong Chan

AU - Kim, Chong Jim

AU - Jeong, Myung Ho

AU - Kim, Young Jo

AU - Kim, Chong Jin

AU - Cho, Myeong Chan

AU - Ahn, Young Keun

AU - Kim, Jong Hyun

AU - Chae, Shung Chull

AU - Hur, Seung Ho

AU - Seong, In Whan

AU - Hong, Taek Jong

AU - Choi, Dong Hoon

AU - Chae, Jei Keon

AU - Rhew, Jae Young

AU - Kim, Doo Il

AU - Chae, In Ho

AU - Yoon, Jung han

AU - Koo, Bon Kwon

AU - Kim, Byung Ok

AU - Lee, Myoung Yong

AU - Kim, Kee Sik

AU - Hwang, Jin Yong

AU - Oh, Seok Kyu

AU - Lee, Nae Hee

AU - Jeong, Kyoung Tae

AU - Tahk, Seung Jea

AU - Bae, Jang Ho

AU - Rha, Seung Woon

AU - Park, Keum Soo

AU - Han, Kyoo Rok

AU - Ahn, Tae Hoon

AU - Kim, Moo Hyun

AU - Yang, Joo Young

AU - Rhim, Chong Yun

AU - Gwon, Hyeon Cheol

AU - Park, Seong Wook

AU - Koh, Young Youp

AU - Joo, Seung Jae

AU - Kim, Soo Joong

AU - Jin, Dong Kyu

AU - Cho, Jin Man

AU - Chung, Wook Sung

AU - Jang, Yang Soo

AU - Cho, Jeong Gwan

AU - Seung, Ki Bae

AU - Park, Seung Jung

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background Successful percutaneous coronary intervention (PCI) of the occluded infarct-related artery (IRA) in latecomers may improve long-term survival mainly by reducing left ventricular remodeling. It is not clear whether inhibition of renin–angiotensin system (RAS) brings additional better clinical outcomes in this specific population subset. Methods Between January 2008 and June 2013, 669 latecomer patients with acute ST-segment elevation myocardial infarction (STEMI) (66.2 ± 12.1 years, 71.0% males) in Korea Acute Myocardial Infarction Registry (KAMIR) who underwent a successful PCI were enrolled. The study population underwent a successful PCI for a totally occluded IRA. They were divided into two groups according to whether they were prescribed RAS inhibitors at the time of discharge: group I (RAS inhibition, n = 556), and group II (no RAS inhibition, n = 113). Results During the one-year follow-up, major adverse cardiac events (MACE), which consist of cardiac death and myocardial infarction, occurred in 71 patients (10.6%). There were significantly reduced incidences of MACE in the group I (hazard ratio = 0.34, 95% confidence interval 0.199–0.588, p = 0.001). In subgroup analyses, RAS inhibition was beneficial in patients with male gender, history of hypertension or diabetes mellitus, and even in patients with left ventricular ejection fraction (LVEF) ≥40%. In the baseline and follow-up echocardiographic data, benefit in changes of LVEF and left ventricular end-systolic volume was noted in group I. Conclusions In latecomers with STEMI, RAS inhibition improved long-term clinical outcomes after a successful PCI, even in patients with low risk who had relatively preserved LVEF.

AB - Background Successful percutaneous coronary intervention (PCI) of the occluded infarct-related artery (IRA) in latecomers may improve long-term survival mainly by reducing left ventricular remodeling. It is not clear whether inhibition of renin–angiotensin system (RAS) brings additional better clinical outcomes in this specific population subset. Methods Between January 2008 and June 2013, 669 latecomer patients with acute ST-segment elevation myocardial infarction (STEMI) (66.2 ± 12.1 years, 71.0% males) in Korea Acute Myocardial Infarction Registry (KAMIR) who underwent a successful PCI were enrolled. The study population underwent a successful PCI for a totally occluded IRA. They were divided into two groups according to whether they were prescribed RAS inhibitors at the time of discharge: group I (RAS inhibition, n = 556), and group II (no RAS inhibition, n = 113). Results During the one-year follow-up, major adverse cardiac events (MACE), which consist of cardiac death and myocardial infarction, occurred in 71 patients (10.6%). There were significantly reduced incidences of MACE in the group I (hazard ratio = 0.34, 95% confidence interval 0.199–0.588, p = 0.001). In subgroup analyses, RAS inhibition was beneficial in patients with male gender, history of hypertension or diabetes mellitus, and even in patients with left ventricular ejection fraction (LVEF) ≥40%. In the baseline and follow-up echocardiographic data, benefit in changes of LVEF and left ventricular end-systolic volume was noted in group I. Conclusions In latecomers with STEMI, RAS inhibition improved long-term clinical outcomes after a successful PCI, even in patients with low risk who had relatively preserved LVEF.

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U2 - 10.1016/j.jjcc.2016.03.012

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