Angiology, 2020.71(2), 139-149, DOI: https://doi.org/10.1177/0003319719884187

ACE Inhibitors Versus ARBs in Patients With NSTEMI With Preserved LV Systolic Function Who Underwent PCI With New Generation Drug-Eluting Stents

Yong Hoon Kim, Myung Ho Jeong; Byeong-Keuk Kim; Sung-Jin Hong; Seunghwan Kim; Chul-Min Ahn; Jung-Sun Kim; Young-Guk Ko; Donghoon Choi; Myeong-Ki Hong; Yangsoo Jang

Abstract

The relative superiority of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) on long-term clinical outcomes in patients with non-ST-segment elevation myocardial infarction (NSTEMI) with preserved left ventricular systolic function in the era of new generation drug-eluting stents is not well established. A total of 6436 patients with NSTEMI (ACEIs group: n = 3965 vs ARBs group: n = 2471) were enrolled. The major clinical end point was the occurrences of major adverse cardiac events (MACEs), defined as all-cause death, recurrent myocardial infarction (re-MI), and any repeat revascularization. After propensity score matching analysis, the cumulative incidences of MACEs (hazard ratio, 1.334; 95% confidence interval, 1.045-1.703; P = .021), any repeat revascularization, and target vessel revascularization (TVR) in the ARB group were significantly higher than that in the ACEI group. However, the cumulative incidences of all-cause death, cardiac death, re-MI, target lesion revascularization, and non-TVR were similar between the 2 groups. Hence, although the mortality and re-MI reduction benefits were similar between the 2 groups, the ACEIs group showed more prominent ability to decrease the occurrences of MACEs, any repeat revascularization, and TVR compared to the ARBs group in these patients during a 2-year follow-up period.

• DOI: https://doi.org/10.1177/0003319719884187
• ISBN or ISSN: 0003-3197

• 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
• This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.