Angiotensin-converting enzyme inhibitors versus angiotensin II receptor blockers in acute ST-segment elevation myocardial infarction patients with diabetes mellitus undergoing percutaneous coronary intervention

Se Yeon Choi, Byoung Geol Choi, Seung-Woon Rha, Jae Kyeong Byun, Min suk Shim, Hu Li, Ahmed Mashaly, Cheol Ung Choi, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Myung Ho Jeong

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background: Diabetes Mellitus (DM) is an important factor of adverse cardiovascular events in acute ST-segment elevation myocardial infarction (STEMI) patients. Renin-angiotensin-aldosterone system (RAAS) inhibitors is associated with improved clinical outcomes, however, there are limited data comparing the effectiveness of two different RAAS inhibitors in STEMI patients with DM undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: A total of 3811 eligible STEMI patients with DM were enrolled in Korea Acute Myocardial Infarction Registry (KAMIR). They were stratified into two groups: Angiotensin converting enzyme inhibitors (ACEI) group (n = 2691) and angiotensin receptor blockers (ARB) group (n = 1120). To adjust baseline confounding factors, we performed propensity score matching (PSM) analysis and evaluated individual and composite major clinical outcomes between the two groups up to 2. years. Results: After PSM, a total of 1049 well-matched pairs were generated. Baseline clinical, angiographic and procedural characteristics were well-balanced between the two groups. The incidence of death, recurrent myocardial infarction (MI), revascularization and major adverse cardiac events (MACE) were not significantly different between the two groups up to 2. years,. Conclusion: In the present study, ACEI and ARB showed comparable effectiveness and safety on individual and composite clinical outcomes in STEMI patients with DM who underwent successful PCI with DES at least up to 2. years.

Original languageEnglish
JournalInternational Journal of Cardiology
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Angiotensin Receptor Antagonists
Percutaneous Coronary Intervention
Angiotensin-Converting Enzyme Inhibitors
Diabetes Mellitus
Myocardial Infarction
Propensity Score
Drug-Eluting Stents
Renin-Angiotensin System
Myocardial Revascularization
Korea
Registries
ST Elevation Myocardial Infarction
Safety
Incidence

Keywords

  • Angiotensin converting enzyme inhibitor
  • Angiotensin II receptor blocker
  • Diabetes mellitus
  • ST-segment myocardial infarction

ASJC Scopus subject areas

  • Medicine(all)
  • Cardiology and Cardiovascular Medicine

Cite this

@article{f741fd8e17cc4987a955f3f374fa095a,
title = "Angiotensin-converting enzyme inhibitors versus angiotensin II receptor blockers in acute ST-segment elevation myocardial infarction patients with diabetes mellitus undergoing percutaneous coronary intervention",
abstract = "Background: Diabetes Mellitus (DM) is an important factor of adverse cardiovascular events in acute ST-segment elevation myocardial infarction (STEMI) patients. Renin-angiotensin-aldosterone system (RAAS) inhibitors is associated with improved clinical outcomes, however, there are limited data comparing the effectiveness of two different RAAS inhibitors in STEMI patients with DM undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: A total of 3811 eligible STEMI patients with DM were enrolled in Korea Acute Myocardial Infarction Registry (KAMIR). They were stratified into two groups: Angiotensin converting enzyme inhibitors (ACEI) group (n = 2691) and angiotensin receptor blockers (ARB) group (n = 1120). To adjust baseline confounding factors, we performed propensity score matching (PSM) analysis and evaluated individual and composite major clinical outcomes between the two groups up to 2. years. Results: After PSM, a total of 1049 well-matched pairs were generated. Baseline clinical, angiographic and procedural characteristics were well-balanced between the two groups. The incidence of death, recurrent myocardial infarction (MI), revascularization and major adverse cardiac events (MACE) were not significantly different between the two groups up to 2. years,. Conclusion: In the present study, ACEI and ARB showed comparable effectiveness and safety on individual and composite clinical outcomes in STEMI patients with DM who underwent successful PCI with DES at least up to 2. years.",
keywords = "Angiotensin converting enzyme inhibitor, Angiotensin II receptor blocker, Diabetes mellitus, ST-segment myocardial infarction",
author = "Choi, {Se Yeon} and Choi, {Byoung Geol} and Seung-Woon Rha and Byun, {Jae Kyeong} and Shim, {Min suk} and Hu Li and Ahmed Mashaly and Choi, {Cheol Ung} and Park, {Chang Gyu} and Seo, {Hong Seog} and Oh, {Dong Joo} and Jeong, {Myung Ho}",
year = "2017",
doi = "10.1016/j.ijcard.2017.08.030",
language = "English",
journal = "International Journal of Cardiology",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",

}

TY - JOUR

T1 - Angiotensin-converting enzyme inhibitors versus angiotensin II receptor blockers in acute ST-segment elevation myocardial infarction patients with diabetes mellitus undergoing percutaneous coronary intervention

AU - Choi, Se Yeon

AU - Choi, Byoung Geol

AU - Rha, Seung-Woon

AU - Byun, Jae Kyeong

AU - Shim, Min suk

AU - Li, Hu

AU - Mashaly, Ahmed

AU - Choi, Cheol Ung

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

AU - Jeong, Myung Ho

PY - 2017

Y1 - 2017

N2 - Background: Diabetes Mellitus (DM) is an important factor of adverse cardiovascular events in acute ST-segment elevation myocardial infarction (STEMI) patients. Renin-angiotensin-aldosterone system (RAAS) inhibitors is associated with improved clinical outcomes, however, there are limited data comparing the effectiveness of two different RAAS inhibitors in STEMI patients with DM undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: A total of 3811 eligible STEMI patients with DM were enrolled in Korea Acute Myocardial Infarction Registry (KAMIR). They were stratified into two groups: Angiotensin converting enzyme inhibitors (ACEI) group (n = 2691) and angiotensin receptor blockers (ARB) group (n = 1120). To adjust baseline confounding factors, we performed propensity score matching (PSM) analysis and evaluated individual and composite major clinical outcomes between the two groups up to 2. years. Results: After PSM, a total of 1049 well-matched pairs were generated. Baseline clinical, angiographic and procedural characteristics were well-balanced between the two groups. The incidence of death, recurrent myocardial infarction (MI), revascularization and major adverse cardiac events (MACE) were not significantly different between the two groups up to 2. years,. Conclusion: In the present study, ACEI and ARB showed comparable effectiveness and safety on individual and composite clinical outcomes in STEMI patients with DM who underwent successful PCI with DES at least up to 2. years.

AB - Background: Diabetes Mellitus (DM) is an important factor of adverse cardiovascular events in acute ST-segment elevation myocardial infarction (STEMI) patients. Renin-angiotensin-aldosterone system (RAAS) inhibitors is associated with improved clinical outcomes, however, there are limited data comparing the effectiveness of two different RAAS inhibitors in STEMI patients with DM undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods: A total of 3811 eligible STEMI patients with DM were enrolled in Korea Acute Myocardial Infarction Registry (KAMIR). They were stratified into two groups: Angiotensin converting enzyme inhibitors (ACEI) group (n = 2691) and angiotensin receptor blockers (ARB) group (n = 1120). To adjust baseline confounding factors, we performed propensity score matching (PSM) analysis and evaluated individual and composite major clinical outcomes between the two groups up to 2. years. Results: After PSM, a total of 1049 well-matched pairs were generated. Baseline clinical, angiographic and procedural characteristics were well-balanced between the two groups. The incidence of death, recurrent myocardial infarction (MI), revascularization and major adverse cardiac events (MACE) were not significantly different between the two groups up to 2. years,. Conclusion: In the present study, ACEI and ARB showed comparable effectiveness and safety on individual and composite clinical outcomes in STEMI patients with DM who underwent successful PCI with DES at least up to 2. years.

KW - Angiotensin converting enzyme inhibitor

KW - Angiotensin II receptor blocker

KW - Diabetes mellitus

KW - ST-segment myocardial infarction

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DO - 10.1016/j.ijcard.2017.08.030

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