TY - JOUR
T1 - Long-term use of renin-angiotensin-system inhibitors after acute myocardial infarction is not associated with survival benefits
T2 - Analysis of data from the Korean acute myocardial infarction registry-national institutes of health registry
AU - the KAMIR-NIH Registry
AU - Park, Chan Soon
AU - Yang, Han Mo
AU - Kang, Jeehoon
AU - Han, Jung Kyu
AU - Park, Kyung Woo
AU - Kang, Hyun Jae
AU - Koo, Bon Kwon
AU - Seung, Ki Bae
AU - Cha, Kwang Soo
AU - Seong, In Whan
AU - Rha, Seung Woon
AU - Jeong, Myung Ho
AU - Kim, Hyo Soo
N1 - Funding Information:
This work was supported by the Korea Health Technology R&D Project “Korea Research-Driven Hospital (grant no. HI14C1277),” “The Strategic Center of Cell and Bio Therapy (grant no. HI17C2085)” through the Korea Health Industry Development Institute (KHIDI), and “The National Research Foundation of Korea (NRF)” (grant no. 2020R1A2C1011311) funded by the Korea Government.
Publisher Copyright:
Copyright © 2022 Park, Yang, Kang, Han, Park, Kang, Koo, Seung, Cha, Seong, Rha, Jeong and Kim.
PY - 2022/8/31
Y1 - 2022/8/31
N2 - Introduction: Renin-angiotensin-system inhibitors (RASi) have shown survival benefits after acute myocardial infarction (MI), but the role of routine long-term use of RASi remains unclear. Thereby, we explored the therapeutic effects of RASi medication at 1-year follow-up from acute MI. Methods: Using the nationwide Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH) registry, we included and analyzed 10,822 subjects. Patients were stratified into those taking RASi at 1-year follow-up (n = 7,696) and those not taking RASi at 1-year follow-up (n = 3,126). Patients were followed up for 2-years from the 1-year follow-up; 2-year all-cause mortality and cardiac mortality were analyzed as primary and secondary outcomes, respectively. Results: The use of RASi at 1-year follow-up was not associated with decreased all-cause mortality (log-rank P = 0.195) or cardiac mortality (log-rank P = 0.337). In multivariate analyses, RASi medication at 1-year follow-up did not reduce all-cause mortality (P = 0.758) or cardiac mortality (P = 0.923), while RASi medication at discharge substantially reduced 1-year all-cause and cardiac mortality. Treatment with either an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker at 1-year follow-up did not show survival benefits from 1-year follow-up, respectively. The use of RASi at 1-year follow-up did not show a prognostic interaction between previous history of chronic kidney disease, post-MI acute heart failure, concomitant use of beta-blockers at 1-year follow-up, or 1-year LVEF. Conclusion: Acute MI patients taking RASi at 1-year follow-up were not associated with improved 2-year all-cause mortality or cardiac mortality from the 1-year follow-up. This study provides valuable information regarding tailored medication strategy after acute MI. Clinical trial registration: [www.ClinicalTrials.gov], identifier [KCT0000863].
AB - Introduction: Renin-angiotensin-system inhibitors (RASi) have shown survival benefits after acute myocardial infarction (MI), but the role of routine long-term use of RASi remains unclear. Thereby, we explored the therapeutic effects of RASi medication at 1-year follow-up from acute MI. Methods: Using the nationwide Korea Acute Myocardial Infarction Registry-National Institutes of Health (KAMIR-NIH) registry, we included and analyzed 10,822 subjects. Patients were stratified into those taking RASi at 1-year follow-up (n = 7,696) and those not taking RASi at 1-year follow-up (n = 3,126). Patients were followed up for 2-years from the 1-year follow-up; 2-year all-cause mortality and cardiac mortality were analyzed as primary and secondary outcomes, respectively. Results: The use of RASi at 1-year follow-up was not associated with decreased all-cause mortality (log-rank P = 0.195) or cardiac mortality (log-rank P = 0.337). In multivariate analyses, RASi medication at 1-year follow-up did not reduce all-cause mortality (P = 0.758) or cardiac mortality (P = 0.923), while RASi medication at discharge substantially reduced 1-year all-cause and cardiac mortality. Treatment with either an angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker at 1-year follow-up did not show survival benefits from 1-year follow-up, respectively. The use of RASi at 1-year follow-up did not show a prognostic interaction between previous history of chronic kidney disease, post-MI acute heart failure, concomitant use of beta-blockers at 1-year follow-up, or 1-year LVEF. Conclusion: Acute MI patients taking RASi at 1-year follow-up were not associated with improved 2-year all-cause mortality or cardiac mortality from the 1-year follow-up. This study provides valuable information regarding tailored medication strategy after acute MI. Clinical trial registration: [www.ClinicalTrials.gov], identifier [KCT0000863].
KW - acute myocardial infarction
KW - angiotensin II receptor blocker
KW - angiotensin converting enzyme inhibitor
KW - mortality
KW - prognosis
KW - renin-angiotensin-system inhibitor
UR - http://www.scopus.com/inward/record.url?scp=85138379312&partnerID=8YFLogxK
U2 - 10.3389/fcvm.2022.994419
DO - 10.3389/fcvm.2022.994419
M3 - Article
AN - SCOPUS:85138379312
VL - 9
JO - Frontiers in Cardiovascular Medicine
JF - Frontiers in Cardiovascular Medicine
SN - 2297-055X
M1 - 994419
ER -