Clinical Outcomes at 2 Years Between Beta-Blockade with ACE Inhibitors or ARBs in Patients with AMI Who Underwent Successful PCI with DES: A Retrospective Analysis of 23,978 Patients in the Korea AMI Registry

Yong Hoon Kim, Ae Young Her, Myung Ho Jeong, Byeong Keuk Kim, Sung Jin Hong, Dong Ho Shin, Jung Sun Kim, Young Guk Ko, Donghoon Choi, Myeongki Hong, Yangsoo Jang

Research output: Contribution to journalArticle

Abstract

Introduction: Data concerning the clinical impact of combination therapy with β-blockers (BBs) + angiotensin-converting enzyme inhibitors (ACEIs) compared with BBs + angiotensin-receptor blockers (ARBs) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) are limited. Objective: We compared the clinical outcomes at 2 years between these two combination therapies. Methods: We enrolled 23,978 patients with AMI who underwent successful PCI with DES between January 2005 and June 2015 from the Korea AMI Registry (KAMIR) and divided them into the two groups: BB + ACEI (n = 17,310) and BB + ARB (n = 6668). The primary endpoint was major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (re-MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and non-TVR. The secondary endpoints were the cumulative incidences of individual components of MACE and target vessel failure (TVF), a composite of death related to the target vessel, re-MI, or clinically driven TVR. Results: The relative risk of MACE was higher in the BB + ARB group than in the BB + ACEI group after propensity score-matched (PSM) analysis (hazard ratio [HR] 1.204; 95% confidence interval [CI] 1.057–1.370; p = 0.005). The relative risks of all-cause death (HR 1.435 [95% CI 1.117–1.845]; p = 0.005), cardiac death (HR 1.733 [95% CI 1.253–2.396]; p = 0.001), TVR (HR 1.437 [95% CI 1.157–1.784]; p = 0.001), and TVF (HR 1.231 [95% CI 1.065–1.424]; p = 0.005) were also higher in the BB + ARB group after PSM. Conclusions: The BB + ACEI group demonstrated reduced cumulative incidences of MACE, all-cause death, cardiac death, TVR, and TVF compared with the BB + ARB group in patients with AMI who underwent successful PCI with DES during a 2-year follow-up period.

Original languageEnglish
Pages (from-to)403-414
Number of pages12
JournalAmerican Journal of Cardiovascular Drugs
Volume19
Issue number4
DOIs
Publication statusPublished - 2019 Aug 1

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Drug-Eluting Stents
Angiotensin Receptor Antagonists
Percutaneous Coronary Intervention
Korea
Angiotensin-Converting Enzyme Inhibitors
Registries
Myocardial Infarction
Confidence Intervals
Cause of Death
Propensity Score
Incidence
Therapeutics

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

Cite this

Kim, Yong Hoon ; Her, Ae Young ; Jeong, Myung Ho ; Kim, Byeong Keuk ; Hong, Sung Jin ; Shin, Dong Ho ; Kim, Jung Sun ; Ko, Young Guk ; Choi, Donghoon ; Hong, Myeongki ; Jang, Yangsoo. / Clinical Outcomes at 2 Years Between Beta-Blockade with ACE Inhibitors or ARBs in Patients with AMI Who Underwent Successful PCI with DES : A Retrospective Analysis of 23,978 Patients in the Korea AMI Registry. In: American Journal of Cardiovascular Drugs. 2019 ; Vol. 19, No. 4. pp. 403-414.
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abstract = "Introduction: Data concerning the clinical impact of combination therapy with β-blockers (BBs) + angiotensin-converting enzyme inhibitors (ACEIs) compared with BBs + angiotensin-receptor blockers (ARBs) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) are limited. Objective: We compared the clinical outcomes at 2 years between these two combination therapies. Methods: We enrolled 23,978 patients with AMI who underwent successful PCI with DES between January 2005 and June 2015 from the Korea AMI Registry (KAMIR) and divided them into the two groups: BB + ACEI (n = 17,310) and BB + ARB (n = 6668). The primary endpoint was major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (re-MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and non-TVR. The secondary endpoints were the cumulative incidences of individual components of MACE and target vessel failure (TVF), a composite of death related to the target vessel, re-MI, or clinically driven TVR. Results: The relative risk of MACE was higher in the BB + ARB group than in the BB + ACEI group after propensity score-matched (PSM) analysis (hazard ratio [HR] 1.204; 95{\%} confidence interval [CI] 1.057–1.370; p = 0.005). The relative risks of all-cause death (HR 1.435 [95{\%} CI 1.117–1.845]; p = 0.005), cardiac death (HR 1.733 [95{\%} CI 1.253–2.396]; p = 0.001), TVR (HR 1.437 [95{\%} CI 1.157–1.784]; p = 0.001), and TVF (HR 1.231 [95{\%} CI 1.065–1.424]; p = 0.005) were also higher in the BB + ARB group after PSM. Conclusions: The BB + ACEI group demonstrated reduced cumulative incidences of MACE, all-cause death, cardiac death, TVR, and TVF compared with the BB + ARB group in patients with AMI who underwent successful PCI with DES during a 2-year follow-up period.",
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Clinical Outcomes at 2 Years Between Beta-Blockade with ACE Inhibitors or ARBs in Patients with AMI Who Underwent Successful PCI with DES : A Retrospective Analysis of 23,978 Patients in the Korea AMI Registry. / Kim, Yong Hoon; Her, Ae Young; Jeong, Myung Ho; Kim, Byeong Keuk; Hong, Sung Jin; Shin, Dong Ho; Kim, Jung Sun; Ko, Young Guk; Choi, Donghoon; Hong, Myeongki; Jang, Yangsoo.

In: American Journal of Cardiovascular Drugs, Vol. 19, No. 4, 01.08.2019, p. 403-414.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clinical Outcomes at 2 Years Between Beta-Blockade with ACE Inhibitors or ARBs in Patients with AMI Who Underwent Successful PCI with DES

T2 - A Retrospective Analysis of 23,978 Patients in the Korea AMI Registry

AU - Kim, Yong Hoon

AU - Her, Ae Young

AU - Jeong, Myung Ho

AU - Kim, Byeong Keuk

AU - Hong, Sung Jin

AU - Shin, Dong Ho

AU - Kim, Jung Sun

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Hong, Myeongki

AU - Jang, Yangsoo

PY - 2019/8/1

Y1 - 2019/8/1

N2 - Introduction: Data concerning the clinical impact of combination therapy with β-blockers (BBs) + angiotensin-converting enzyme inhibitors (ACEIs) compared with BBs + angiotensin-receptor blockers (ARBs) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) are limited. Objective: We compared the clinical outcomes at 2 years between these two combination therapies. Methods: We enrolled 23,978 patients with AMI who underwent successful PCI with DES between January 2005 and June 2015 from the Korea AMI Registry (KAMIR) and divided them into the two groups: BB + ACEI (n = 17,310) and BB + ARB (n = 6668). The primary endpoint was major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (re-MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and non-TVR. The secondary endpoints were the cumulative incidences of individual components of MACE and target vessel failure (TVF), a composite of death related to the target vessel, re-MI, or clinically driven TVR. Results: The relative risk of MACE was higher in the BB + ARB group than in the BB + ACEI group after propensity score-matched (PSM) analysis (hazard ratio [HR] 1.204; 95% confidence interval [CI] 1.057–1.370; p = 0.005). The relative risks of all-cause death (HR 1.435 [95% CI 1.117–1.845]; p = 0.005), cardiac death (HR 1.733 [95% CI 1.253–2.396]; p = 0.001), TVR (HR 1.437 [95% CI 1.157–1.784]; p = 0.001), and TVF (HR 1.231 [95% CI 1.065–1.424]; p = 0.005) were also higher in the BB + ARB group after PSM. Conclusions: The BB + ACEI group demonstrated reduced cumulative incidences of MACE, all-cause death, cardiac death, TVR, and TVF compared with the BB + ARB group in patients with AMI who underwent successful PCI with DES during a 2-year follow-up period.

AB - Introduction: Data concerning the clinical impact of combination therapy with β-blockers (BBs) + angiotensin-converting enzyme inhibitors (ACEIs) compared with BBs + angiotensin-receptor blockers (ARBs) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) are limited. Objective: We compared the clinical outcomes at 2 years between these two combination therapies. Methods: We enrolled 23,978 patients with AMI who underwent successful PCI with DES between January 2005 and June 2015 from the Korea AMI Registry (KAMIR) and divided them into the two groups: BB + ACEI (n = 17,310) and BB + ARB (n = 6668). The primary endpoint was major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (re-MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and non-TVR. The secondary endpoints were the cumulative incidences of individual components of MACE and target vessel failure (TVF), a composite of death related to the target vessel, re-MI, or clinically driven TVR. Results: The relative risk of MACE was higher in the BB + ARB group than in the BB + ACEI group after propensity score-matched (PSM) analysis (hazard ratio [HR] 1.204; 95% confidence interval [CI] 1.057–1.370; p = 0.005). The relative risks of all-cause death (HR 1.435 [95% CI 1.117–1.845]; p = 0.005), cardiac death (HR 1.733 [95% CI 1.253–2.396]; p = 0.001), TVR (HR 1.437 [95% CI 1.157–1.784]; p = 0.001), and TVF (HR 1.231 [95% CI 1.065–1.424]; p = 0.005) were also higher in the BB + ARB group after PSM. Conclusions: The BB + ACEI group demonstrated reduced cumulative incidences of MACE, all-cause death, cardiac death, TVR, and TVF compared with the BB + ARB group in patients with AMI who underwent successful PCI with DES during a 2-year follow-up period.

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