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Observational Study
. 2020 Jul 24;99(30):e21289.
doi: 10.1097/MD.0000000000021289.

Impacts of renin-angiotensin system inhibitors on two-year clinical outcomes in diabetic and dyslipidemic acute myocardial infarction patients after a successful percutaneous coronary intervention using newer-generation drug-eluting stents

Yong Hoon Kim  1 , Ae-Young Her  1 , Myung Ho Jeong  2 , Byeong-Keuk Kim  3 , Sung-Jin Hong  3 , Seunghwan Kim  4 , Chul-Min Ahn  3 , Jung-Sun Kim  3 , Young-Guk Ko  3 , Donghoon Choi  3 , Myeong-Ki Hong  3 , Yangsoo Jang  3
Affiliations
Observational Study

Impacts of renin-angiotensin system inhibitors on two-year clinical outcomes in diabetic and dyslipidemic acute myocardial infarction patients after a successful percutaneous coronary intervention using newer-generation drug-eluting stents

Yong Hoon Kim et al. Medicine (Baltimore). .

Abstract

This study investigated the impacts of renin-angiotensin system inhibitors (RASIs) on 2-year clinical outcomes in diabetes and dyslipidemic acute myocardial infarction (AMI) patients after a successful percutaneous coronary intervention (PCI) using newer-generation drug-eluting stents (DESs).A total of 16,997 AMI patients were enrolled, and divided into four groups based on the presence or absence of diabetes and dyslipidemia as follows: diabetes -/dyslipidemia -(group A, 11,132 patients), diabetes +/dyslipidemia - (group B, 3,860 patients), diabetes -/dyslipidemia + (group C, 1,328 patients), and diabetes +/dyslipidemia + (group D, 677 patients). The clinical endpoint was the occurrence of major adverse cardiac events (MACEs), the composite of total death, recurrent myocardial infarction (re-MI), and any repeat revascularization, including target lesion revascularization (TLR), target vessel revascularization (TVR), and non-target vessel revascularization (non-TVR).After RASIs therapy, the cumulative incidences of MACEs (adjusted hazard ratio [aHR], 1.330; 95% confidence interval [CI], 1.022-1.732; P = .034), any repeat revascularization (aHR, 1.584; 95% CI, 1.092-2.298; P = .015), TLR, and TVR were significantly higher in group B than group C. However, the cumulative incidences of all-cause death, cardiac death, re-MI, and non-TVR were similar in groups B and C.In this study, under the newer-generation DESs era, repeat revascularization rate reduction benefit of RASIs therapy in diabetic AMI patients was lesser than that in dyslipidemic AMI patients. However, larger randomized controlled studies are needed to confirm these results in the future.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Flow chart.
Figure 2
Figure 2
Kaplan–Meier curved analysis for MACEs (A), all-cause death (B), cardiac death (C), re-MI (D), any repeat revascularization (E), TLR (F), and TVR (G).
Figure 2 (Continued)
Figure 2 (Continued)
Kaplan–Meier curved analysis for MACEs (A), all-cause death (B), cardiac death (C), re-MI (D), any repeat revascularization (E), TLR (F), and TVR (G).
Figure 3
Figure 3
Subgroup analysis for MACEs between the group B and the group C at 2 years.
See this image and copyright information in PMC

References

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