Impact of renin angiotensin system inhibitor on 3-year clinical outcomes in acute myocardial infarction patients with preserved left ventricular systolic function: a prospective cohort study from Korea Acute Myocardial Infarction Registry (KAMIR)

Other KAMIR-NIH investigators

doi:10.1186/s12872-021-02070-x

Impact of renin angiotensin system inhibitor on 3-year clinical outcomes in acute myocardial infarction patients with preserved left ventricular systolic function: a prospective cohort study from Korea Acute Myocardial Infarction Registry (KAMIR)

Other KAMIR-NIH investigators

Internal Medicine

Research output: Contribution to journal › Article › peer-review

2 Citations (Scopus)

Abstract

Background: Patients with acute myocardial infarction (AMI) are usually treated with angiotensin-converting enzyme inhibitors (ACEIs), or angiotensin receptor blockers (ARBs) if ACEIs are not tolerated. However, there is no data regarding the impact of switching from ACEIs to ARBs on long-term clinical outcomes in AMI patients with preserved left ventricular (LV) systolic function especially beyond 1 year. To investigate the effectiveness of treatment with ACEIs or ARBs on clinical outcomes over 3 years in AMI patients with preserved LV systolic function following percutaneous coronary intervention. Method: It is a prospective cohort study using data from a nationwide large scale registry with 53 hospitals involved in treatment of acute myocardial infarction (AMI) in Korea. Between March 2011 and September 2015, we enrolled 6236 patients with AMI who underwent primary percutaneous coronary intervention and had a left ventricular ejection fraction ≥ 50%. Main outcome measures composite of total death or recurrent AMI over 3 years after AMI. Patients were divided into an ACEI group (n = 2945), ARB group (n = 2197), or no renin-angiotensin system inhibitor (RASI) treatment (n = 1094). We analyzed patients who changed treatment. Inverse probability of treatment weighting (IPTW) analysis was also performed. Results: After the adjustment with inverse probability weighting, the primary endpoints at 1 year, AMI patients receiving ACEIs showed overall better outcomes than ARBs [ARBs hazard ratio (HR) compared with ACEIs 1.384, 95% confidence interval (CI) 1.15–1.71; P = 0.003]. However, 33% of patients receiving ACEIs switched to ARBs during the first year, while only about 1.5% switched from ARBs to ACEIs. When landmark analysis was performed from 1 year to the end of the study, RASI group showed a 31% adjusted reduction in primary endpoint compared to patients with no RASI group (HR, 0.74; 95% CI 0.56–0.97; P = 0.012). Conclusions: This result suggests that certain patients got benefit from treatment with ACEIs in the first year if tolerated, but switching to ARBs beyond the first year produced similar outcomes. RASI beyond the first year reduced death or recurrent AMI in AMI patients with preserved LV systolic function. CRIS Registration number: KCT0004990.

Original language	English
Article number	251
Journal	BMC Cardiovascular Disorders
Volume	21
Issue number	1
DOIs	https://doi.org/10.1186/s12872-021-02070-x
Publication status	Published - 2021 Dec

Bibliographical note

Funding Information:
This study was done with the support of Korean Circulation Society (KCS) to commemorate the 50th Anniversary of KCS. The KAMIR study group of the KSC was as follows: Korea University Guro Hospital, Seoul, South Korea (Seung-Woon Rha), Gachon University Gil Medical Center, Incheon, South Korea (Tae Hoon Ahn), Wonju Severance Christian Hospital, Wonju, South Korea (Junghan Yoon), Seoul National University Hospital, Seoul, South Korea (Hyo-Soo Kim), Seoul St. Mary's Hospital, Seoul, South Korea (Ki-Bae Seung), Samsung Medical Center, Seoul, South Korea (Hyeon-Cheol Gwon), Kyungpook National University Hospital, Daegu, South Korea (Shung Chull Chae), Kyunghee University Hospital At Gangdong, Seoul, South Korea (Chong-Jin Kim), Pusan National University Hospital, Busan, South Korea (Kwang Soo Cha), Yeungnam University Medical Center, Daegu, South Korea (Jung-Hee Lee), Chonbuk National University Hospital, Jeongju, South Korea (Jei Keon Chae), Jeju National University Hospital, Jeju, South Korea (Seung-Jae Joo), Seoul National University Bundang Hospital, Bundang, South Korea (Chang-Hwan Yoon), Keimyung University Dongsan Medical Center, Daegu, South Korea (Seung-Ho Hur), Chungnam National University Hospital, Daejeon, South Korea (In-Whan Seong), Chungbuk National University Hospital, Cheongju, South Korea (Kyung-Kuk Hwang), Inje University Haeundae Paik Hospital, Busan, South Korea (Doo-Il Kim), Wonkwang University Hospital, Iksan, South Korea (Seok Kyu Oh), Gyeongsang National University Hospital, Jinju, South Korea (Jin-Yong Hwang), Chonnam National University Hospital, Gwangju, South Korea (Myung Ho Jeong).

Publisher Copyright:
© 2021, The Author(s).

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine

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10.1186/s12872-021-02070-x

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Other KAMIR-NIH investigators (2021). Impact of renin angiotensin system inhibitor on 3-year clinical outcomes in acute myocardial infarction patients with preserved left ventricular systolic function: a prospective cohort study from Korea Acute Myocardial Infarction Registry (KAMIR). BMC Cardiovascular Disorders, 21(1), [251]. https://doi.org/10.1186/s12872-021-02070-x

@article{a5466450be1649fab7faba3e09158db6,

title = "Impact of renin angiotensin system inhibitor on 3-year clinical outcomes in acute myocardial infarction patients with preserved left ventricular systolic function: a prospective cohort study from Korea Acute Myocardial Infarction Registry (KAMIR)",

abstract = "Background: Patients with acute myocardial infarction (AMI) are usually treated with angiotensin-converting enzyme inhibitors (ACEIs), or angiotensin receptor blockers (ARBs) if ACEIs are not tolerated. However, there is no data regarding the impact of switching from ACEIs to ARBs on long-term clinical outcomes in AMI patients with preserved left ventricular (LV) systolic function especially beyond 1 year. To investigate the effectiveness of treatment with ACEIs or ARBs on clinical outcomes over 3 years in AMI patients with preserved LV systolic function following percutaneous coronary intervention. Method: It is a prospective cohort study using data from a nationwide large scale registry with 53 hospitals involved in treatment of acute myocardial infarction (AMI) in Korea. Between March 2011 and September 2015, we enrolled 6236 patients with AMI who underwent primary percutaneous coronary intervention and had a left ventricular ejection fraction ≥ 50%. Main outcome measures composite of total death or recurrent AMI over 3 years after AMI. Patients were divided into an ACEI group (n = 2945), ARB group (n = 2197), or no renin-angiotensin system inhibitor (RASI) treatment (n = 1094). We analyzed patients who changed treatment. Inverse probability of treatment weighting (IPTW) analysis was also performed. Results: After the adjustment with inverse probability weighting, the primary endpoints at 1 year, AMI patients receiving ACEIs showed overall better outcomes than ARBs [ARBs hazard ratio (HR) compared with ACEIs 1.384, 95% confidence interval (CI) 1.15–1.71; P = 0.003]. However, 33% of patients receiving ACEIs switched to ARBs during the first year, while only about 1.5% switched from ARBs to ACEIs. When landmark analysis was performed from 1 year to the end of the study, RASI group showed a 31% adjusted reduction in primary endpoint compared to patients with no RASI group (HR, 0.74; 95% CI 0.56–0.97; P = 0.012). Conclusions: This result suggests that certain patients got benefit from treatment with ACEIs in the first year if tolerated, but switching to ARBs beyond the first year produced similar outcomes. RASI beyond the first year reduced death or recurrent AMI in AMI patients with preserved LV systolic function. CRIS Registration number: KCT0004990.",

author = "{Other KAMIR-NIH investigators} and Kim, {Kyung Hee} and Choi, {Byoung Geol} and Rha, {Seung Woon} and Choi, {Cheol Ung} and Jeong, {Myung Ho} and Ahn, {Tae Hoon} and Junghan Yoon and Kim, {Hyo Soo} and Seung, {Ki Bae} and Gwon, {Hyeon Cheol} and Chae, {Shung Chull} and Kim, {Chong Jin} and Cha, {Kwang Soo} and Lee, {Jung Hee} and Chae, {Jei Keon} and Joo, {Seung Jae} and Yoon, {Chang Hwan} and Hur, {Seung Ho} and Seong, {In Whan} and Hwang, {Kyung Kuk} and Kim, {Doo Il} and Oh, {Seok Seok Kyu} and Hwang, {Jin Yong} and Jeong, {Myung Ho}",

note = "Funding Information: This study was done with the support of Korean Circulation Society (KCS) to commemorate the 50th Anniversary of KCS. The KAMIR study group of the KSC was as follows: Korea University Guro Hospital, Seoul, South Korea (Seung-Woon Rha), Gachon University Gil Medical Center, Incheon, South Korea (Tae Hoon Ahn), Wonju Severance Christian Hospital, Wonju, South Korea (Junghan Yoon), Seoul National University Hospital, Seoul, South Korea (Hyo-Soo Kim), Seoul St. Mary's Hospital, Seoul, South Korea (Ki-Bae Seung), Samsung Medical Center, Seoul, South Korea (Hyeon-Cheol Gwon), Kyungpook National University Hospital, Daegu, South Korea (Shung Chull Chae), Kyunghee University Hospital At Gangdong, Seoul, South Korea (Chong-Jin Kim), Pusan National University Hospital, Busan, South Korea (Kwang Soo Cha), Yeungnam University Medical Center, Daegu, South Korea (Jung-Hee Lee), Chonbuk National University Hospital, Jeongju, South Korea (Jei Keon Chae), Jeju National University Hospital, Jeju, South Korea (Seung-Jae Joo), Seoul National University Bundang Hospital, Bundang, South Korea (Chang-Hwan Yoon), Keimyung University Dongsan Medical Center, Daegu, South Korea (Seung-Ho Hur), Chungnam National University Hospital, Daejeon, South Korea (In-Whan Seong), Chungbuk National University Hospital, Cheongju, South Korea (Kyung-Kuk Hwang), Inje University Haeundae Paik Hospital, Busan, South Korea (Doo-Il Kim), Wonkwang University Hospital, Iksan, South Korea (Seok Kyu Oh), Gyeongsang National University Hospital, Jinju, South Korea (Jin-Yong Hwang), Chonnam National University Hospital, Gwangju, South Korea (Myung Ho Jeong). Publisher Copyright: {\textcopyright} 2021, The Author(s).",

year = "2021",

month = dec,

doi = "10.1186/s12872-021-02070-x",

language = "English",

volume = "21",

journal = "BMC Cardiovascular Disorders",

issn = "1471-2261",

publisher = "BioMed Central",

number = "1",

}

Other KAMIR-NIH investigators 2021, 'Impact of renin angiotensin system inhibitor on 3-year clinical outcomes in acute myocardial infarction patients with preserved left ventricular systolic function: a prospective cohort study from Korea Acute Myocardial Infarction Registry (KAMIR)', BMC Cardiovascular Disorders, vol. 21, no. 1, 251. https://doi.org/10.1186/s12872-021-02070-x

Impact of renin angiotensin system inhibitor on 3-year clinical outcomes in acute myocardial infarction patients with preserved left ventricular systolic function : a prospective cohort study from Korea Acute Myocardial Infarction Registry (KAMIR). / Other KAMIR-NIH investigators.

In: BMC Cardiovascular Disorders, Vol. 21, No. 1, 251, 12.2021.

Research output: Contribution to journal › Article › peer-review

TY - JOUR

T1 - Impact of renin angiotensin system inhibitor on 3-year clinical outcomes in acute myocardial infarction patients with preserved left ventricular systolic function

T2 - a prospective cohort study from Korea Acute Myocardial Infarction Registry (KAMIR)

AU - Other KAMIR-NIH investigators

AU - Kim, Kyung Hee

AU - Choi, Byoung Geol

AU - Rha, Seung Woon

AU - Choi, Cheol Ung

AU - Jeong, Myung Ho

AU - Ahn, Tae Hoon

AU - Yoon, Junghan

AU - Kim, Hyo Soo

AU - Seung, Ki Bae

AU - Gwon, Hyeon Cheol

AU - Chae, Shung Chull

AU - Kim, Chong Jin

AU - Cha, Kwang Soo

AU - Lee, Jung Hee

AU - Chae, Jei Keon

AU - Joo, Seung Jae

AU - Yoon, Chang Hwan

AU - Hur, Seung Ho

AU - Seong, In Whan

AU - Hwang, Kyung Kuk

AU - Kim, Doo Il

AU - Oh, Seok Seok Kyu

AU - Hwang, Jin Yong

AU - Jeong, Myung Ho

N1 - Funding Information: This study was done with the support of Korean Circulation Society (KCS) to commemorate the 50th Anniversary of KCS. The KAMIR study group of the KSC was as follows: Korea University Guro Hospital, Seoul, South Korea (Seung-Woon Rha), Gachon University Gil Medical Center, Incheon, South Korea (Tae Hoon Ahn), Wonju Severance Christian Hospital, Wonju, South Korea (Junghan Yoon), Seoul National University Hospital, Seoul, South Korea (Hyo-Soo Kim), Seoul St. Mary's Hospital, Seoul, South Korea (Ki-Bae Seung), Samsung Medical Center, Seoul, South Korea (Hyeon-Cheol Gwon), Kyungpook National University Hospital, Daegu, South Korea (Shung Chull Chae), Kyunghee University Hospital At Gangdong, Seoul, South Korea (Chong-Jin Kim), Pusan National University Hospital, Busan, South Korea (Kwang Soo Cha), Yeungnam University Medical Center, Daegu, South Korea (Jung-Hee Lee), Chonbuk National University Hospital, Jeongju, South Korea (Jei Keon Chae), Jeju National University Hospital, Jeju, South Korea (Seung-Jae Joo), Seoul National University Bundang Hospital, Bundang, South Korea (Chang-Hwan Yoon), Keimyung University Dongsan Medical Center, Daegu, South Korea (Seung-Ho Hur), Chungnam National University Hospital, Daejeon, South Korea (In-Whan Seong), Chungbuk National University Hospital, Cheongju, South Korea (Kyung-Kuk Hwang), Inje University Haeundae Paik Hospital, Busan, South Korea (Doo-Il Kim), Wonkwang University Hospital, Iksan, South Korea (Seok Kyu Oh), Gyeongsang National University Hospital, Jinju, South Korea (Jin-Yong Hwang), Chonnam National University Hospital, Gwangju, South Korea (Myung Ho Jeong). Publisher Copyright: © 2021, The Author(s).

PY - 2021/12

Y1 - 2021/12

N2 - Background: Patients with acute myocardial infarction (AMI) are usually treated with angiotensin-converting enzyme inhibitors (ACEIs), or angiotensin receptor blockers (ARBs) if ACEIs are not tolerated. However, there is no data regarding the impact of switching from ACEIs to ARBs on long-term clinical outcomes in AMI patients with preserved left ventricular (LV) systolic function especially beyond 1 year. To investigate the effectiveness of treatment with ACEIs or ARBs on clinical outcomes over 3 years in AMI patients with preserved LV systolic function following percutaneous coronary intervention. Method: It is a prospective cohort study using data from a nationwide large scale registry with 53 hospitals involved in treatment of acute myocardial infarction (AMI) in Korea. Between March 2011 and September 2015, we enrolled 6236 patients with AMI who underwent primary percutaneous coronary intervention and had a left ventricular ejection fraction ≥ 50%. Main outcome measures composite of total death or recurrent AMI over 3 years after AMI. Patients were divided into an ACEI group (n = 2945), ARB group (n = 2197), or no renin-angiotensin system inhibitor (RASI) treatment (n = 1094). We analyzed patients who changed treatment. Inverse probability of treatment weighting (IPTW) analysis was also performed. Results: After the adjustment with inverse probability weighting, the primary endpoints at 1 year, AMI patients receiving ACEIs showed overall better outcomes than ARBs [ARBs hazard ratio (HR) compared with ACEIs 1.384, 95% confidence interval (CI) 1.15–1.71; P = 0.003]. However, 33% of patients receiving ACEIs switched to ARBs during the first year, while only about 1.5% switched from ARBs to ACEIs. When landmark analysis was performed from 1 year to the end of the study, RASI group showed a 31% adjusted reduction in primary endpoint compared to patients with no RASI group (HR, 0.74; 95% CI 0.56–0.97; P = 0.012). Conclusions: This result suggests that certain patients got benefit from treatment with ACEIs in the first year if tolerated, but switching to ARBs beyond the first year produced similar outcomes. RASI beyond the first year reduced death or recurrent AMI in AMI patients with preserved LV systolic function. CRIS Registration number: KCT0004990.

AB - Background: Patients with acute myocardial infarction (AMI) are usually treated with angiotensin-converting enzyme inhibitors (ACEIs), or angiotensin receptor blockers (ARBs) if ACEIs are not tolerated. However, there is no data regarding the impact of switching from ACEIs to ARBs on long-term clinical outcomes in AMI patients with preserved left ventricular (LV) systolic function especially beyond 1 year. To investigate the effectiveness of treatment with ACEIs or ARBs on clinical outcomes over 3 years in AMI patients with preserved LV systolic function following percutaneous coronary intervention. Method: It is a prospective cohort study using data from a nationwide large scale registry with 53 hospitals involved in treatment of acute myocardial infarction (AMI) in Korea. Between March 2011 and September 2015, we enrolled 6236 patients with AMI who underwent primary percutaneous coronary intervention and had a left ventricular ejection fraction ≥ 50%. Main outcome measures composite of total death or recurrent AMI over 3 years after AMI. Patients were divided into an ACEI group (n = 2945), ARB group (n = 2197), or no renin-angiotensin system inhibitor (RASI) treatment (n = 1094). We analyzed patients who changed treatment. Inverse probability of treatment weighting (IPTW) analysis was also performed. Results: After the adjustment with inverse probability weighting, the primary endpoints at 1 year, AMI patients receiving ACEIs showed overall better outcomes than ARBs [ARBs hazard ratio (HR) compared with ACEIs 1.384, 95% confidence interval (CI) 1.15–1.71; P = 0.003]. However, 33% of patients receiving ACEIs switched to ARBs during the first year, while only about 1.5% switched from ARBs to ACEIs. When landmark analysis was performed from 1 year to the end of the study, RASI group showed a 31% adjusted reduction in primary endpoint compared to patients with no RASI group (HR, 0.74; 95% CI 0.56–0.97; P = 0.012). Conclusions: This result suggests that certain patients got benefit from treatment with ACEIs in the first year if tolerated, but switching to ARBs beyond the first year produced similar outcomes. RASI beyond the first year reduced death or recurrent AMI in AMI patients with preserved LV systolic function. CRIS Registration number: KCT0004990.

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UR - http://www.scopus.com/inward/citedby.url?scp=85106710580&partnerID=8YFLogxK

U2 - 10.1186/s12872-021-02070-x

DO - 10.1186/s12872-021-02070-x

M3 - Article

C2 - 34020593

AN - SCOPUS:85106710580

SN - 1471-2261

VL - 21

JO - BMC Cardiovascular Disorders

JF - BMC Cardiovascular Disorders

IS - 1

M1 - 251

ER -

Impact of renin angiotensin system inhibitor on 3-year clinical outcomes in acute myocardial infarction patients with preserved left ventricular systolic function: a prospective cohort study from Korea Acute Myocardial Infarction Registry (KAMIR)

Abstract

Bibliographical note

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