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Role of renin-angiotensin system antagonists on long-term mortality post-percutaneous coronary intervention in reduced and preserved ejection fraction.
Prosser, Hamish C; Peck, Kah Yong; Dinh, Diem; Roberts, Louise; Chandrasekhar, Jaya; Brennan, Angela; Duffy, Stephen J; Clark, David; Ajani, Andrew E; Oqueli, Ernesto; Sebastian, Martin; Reid, Christopher M; Freeman, Melanie; Sajeev, Jithin K; Teh, Andrew W.
Afiliación
  • Prosser HC; Department of Cardiology, Eastern Health, Box Hill Hospital, Level 2, 8 Arnold Street, Box Hill, VIC, 3128, Australia.
  • Peck KY; Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.
  • Dinh D; Department of Cardiology, Eastern Health, Box Hill Hospital, Level 2, 8 Arnold Street, Box Hill, VIC, 3128, Australia.
  • Roberts L; Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.
  • Chandrasekhar J; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
  • Brennan A; Department of Cardiology, Eastern Health, Box Hill Hospital, Level 2, 8 Arnold Street, Box Hill, VIC, 3128, Australia.
  • Duffy SJ; Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.
  • Clark D; Department of Cardiology, Eastern Health, Box Hill Hospital, Level 2, 8 Arnold Street, Box Hill, VIC, 3128, Australia.
  • Ajani AE; Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.
  • Oqueli E; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
  • Sebastian M; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
  • Reid CM; Department of Cardiology, Alfred Health, The Alfred Hospital, Melbourne, VIC, Australia.
  • Freeman M; Department of Cardiology, Austin Hospital Clinical School, The University of Melbourne, Melbourne, VIC, Australia.
  • Sajeev JK; Department of Cardiology, Royal Melbourne Hospital, Parkville, VIC, Australia.
  • Teh AW; Department of Cardiology, Ballarat Health Services, Ballarat, VIC, Australia.
Clin Res Cardiol ; 111(7): 776-786, 2022 Jul.
Article en En | MEDLINE | ID: mdl-35050405
AIMS: The use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II-receptor blockers (ARBs) post-myocardial infarction (MI) is supported by evidence based on trials performed in the thrombolysis era. This was prior to primary percutaneous coronary intervention (PCI) being routine practice, and with little direct evidence for the use of these medications in patients with preserved left ventricular (LV) function. This study sought to determine whether there is an association between ACEi/ARB use after PCI for acute coronary syndrome (ACS) and long-term all-cause mortality, with a particular focus on patients with preserved LV function. METHODS: This multicentre, observational study evaluated prospectively collected data of 21,388 patients (> 18 years old) that underwent PCI for NSTEMI and STEMI between 2005 and 2018, and were alive at 30 day follow-up. RESULTS: In total, 83.8% of patients were using ACEi/ARBs. Kaplan-Meier analysis demonstrated ACEi/ARB use was associated with a significantly lower mortality in the entire cohort (15.0 vs. 22.7%; p < 0.001) with a mean follow-up of 5.58 years; and independently associated with 24% lower mortality by Cox proportional hazards modelling (HR 0.76, CI 0.67-0.85, p < 0.001). ACEi/ARB therapy was also associated with significantly lower mortality in patients with reduced or preserved LV function, with greater survival benefit with worse LV dysfunction. CONCLUSION: ACEi/ARB therapy post-PCI is associated with significantly lower long-term mortality in patients with reduced and preserved LV function. These findings provide contemporary evidence for using these agents in the current era of routine primary PCI, including those with preserved EF.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antagonistas de Receptores de Angiotensina / Intervención Coronaria Percutánea Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Adolescent / Humans Idioma: En Revista: Clin Res Cardiol Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Alemania
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Antagonistas de Receptores de Angiotensina / Intervención Coronaria Percutánea Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Adolescent / Humans Idioma: En Revista: Clin Res Cardiol Asunto de la revista: CARDIOLOGIA Año: 2022 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Alemania