Angiotensin II type 1 receptor blockers as a first choice in patients with acute myocardial infarction
The Korean Journal of Internal Medicine
;
: 267-276, 2016.
Artigo
em Inglês
| WPRIM
| ID: wpr-36004
ABSTRACT
BACKGROUND/AIMS:
Angiotensin II type 1 receptor blockers (ARBs) have not been adequately evaluated in patients without left ventricular (LV) dysfunction or heart failure after acute myocardial infarction (AMI).METHODS:
Between November 2005 and January 2008, 6,781 patients who were not receiving angiotensin-converting enzyme inhibitors (ACEIs) or ARBs were selected from the Korean AMI Registry. The primary endpoints were 12-month major adverse cardiac events (MACEs) including death and recurrent AMI.RESULTS:
Seventy percent of the patients were Killip class 1 and had a LV ejection fraction > or = 40%. The prescription rate of ARBs was 12.2%. For each patient, a propensity score, indicating the likelihood of using ARBs during hospitalization or at discharge, was calculated using a non-parsimonious multivariable logistic regression model, and was used to match the patients 14, yielding 715 ARB users versus 2,860 ACEI users. The effect of ARBs on in-hospital mortality and 12-month MACE occurrence was assessed using matched logistic and Cox regression models. Compared with ACEIs, ARBs significantly reduced in-hospital mortality(1.3% vs. 3.3%; hazard ratio [HR], 0.379; 95% confidence interval [CI], 0.190 to0.756; p = 0.006) and 12-month MACE occurrence (4.6% vs. 6.9%; HR, 0.661; 95% CI, 0.457 to 0.956; p = 0.028). However, the benefit of ARBs on 12-month mortality compared with ACEIs was marginal (4.3% vs. 6.2%; HR, 0.684; 95% CI, 0.467 to 1.002; p = 0.051).CONCLUSIONS:
Our results suggest that ARBs are not inferior to, and may actually be better than ACEIs in Korean patients with AMI.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Recidiva
/
Volume Sistólico
/
Fatores de Tempo
/
Inibidores da Enzima Conversora de Angiotensina
/
Distribuição de Qui-Quadrado
/
Modelos Logísticos
/
Modelos de Riscos Proporcionais
/
Sistema de Registros
/
Análise Multivariada
/
Estudos Prospectivos
Tipo de estudo:
Estudo de etiologia
/
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
País/Região como assunto:
Ásia
Idioma:
Inglês
Revista:
The Korean Journal of Internal Medicine
Ano de publicação:
2016
Tipo de documento:
Artigo
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