TY - JOUR
T1 - 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
AU - Kim, Yong Hoon
AU - Her, Ae Young
AU - Jeong, Myung Ho
AU - Kim, Byeong Keuk
AU - Hong, Sung Jin
AU - Kim, Seunghwan
AU - Ahn, Chul Min
AU - Kim, Jung Sun
AU - Ko, Young Guk
AU - Choi, Donghoon
AU - Hong, Myeong Ki
AU - Jang, Yangsoo
N1 - Funding Information:
This research was supported by a fund ( 2016-ER6304-02 ) by Research of Korea Centers for Disease Control and Prevention .
PY - 2020/6
Y1 - 2020/6
N2 - 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 = 2,944], RASI− [n = 765]), and diabetes (n = 5,173; RASI+ [n = 4,133], 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.
AB - 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 = 2,944], RASI− [n = 765]), and diabetes (n = 5,173; RASI+ [n = 4,133], 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.
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U2 - 10.1016/j.jdiacomp.2020.107574
DO - 10.1016/j.jdiacomp.2020.107574
M3 - Article
C2 - 32147394
AN - SCOPUS:85081272526
VL - 34
JO - Journal of Diabetes and its Complications
JF - Journal of Diabetes and its Complications
SN - 1056-8727
IS - 6
M1 - 107574
ER -