TY - JOUR
T1 - Comparison of 5-year survival after acute myocardial infarction using angiotensin-converting enzyme inhibitor versus angiotensin ii receptor blocker
AU - Hara, Masahiko
AU - Sakata, Yasuhiko
AU - Nakatani, Daisaku
AU - Suna, Shinichiro
AU - Usami, Masaya
AU - Matsumoto, Sen
AU - Sugitani, Toshifumi
AU - Nishino, Masami
AU - Sato, Hiroshi
AU - Kitamura, Tetsuhisa
AU - Nanto, Shinsuke
AU - Hamasaki, Toshimitsu
AU - Hori, Masatsugu
AU - Komuro, Issei
N1 - Funding Information:
Dr. Komuro has received research grants and speaker's fees from Takeda Pharmaceutical Company, Astellas Pharma, DAIICHI SANKYO COMPANY, Boehringer Ingelheim, Novartis Pharma and Shionogi. No other authors have relationships with industry to disclose or financial associations that might pose a conflict of interest in connection with the submitted article.
Funding Information:
This work was supported by Grants-in-Aid for University and Society Collaboration (#19590816 and #19390215) from the Japanese Ministry of Education, Culture, Sports, Science and Technology , Tokyo, Japan.
PY - 2014/7/1
Y1 - 2014/7/1
N2 - Few studies have investigated whether angiotensin II receptor blocker (ARB) is a practical alternative to angiotensin-converting enzyme inhibitor (ACEI) for long-term use after acute myocardial infarction (AMI) in real-world practice in the percutaneous coronary intervention era. We compared 5-year survival benefits of ACEI and ARB in patients with AMI registered in the Osaka Acute Coronary Insufficiency Study. Study subjects were divided into 3 groups: ACEI (n = 4,425), ARB (n = 2,158), or patients without either drug (n = 2,442). A total of 661 deaths were recorded. Cox regression analysis revealed that treatment with either ACEI or ARB was associated with reduced 5-year mortality (adjusted hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.58 to 0.83, p <0.001 and HR 0.79, 95% CI 0.64 to 0.98, p = 0.03, respectively). However, Kaplan-Meier estimates and Cox regression analyses based on propensity score revealed that ACEI was associated with better survival than ARB from 2 to 5 years after survival discharge (adjusted HR 0.53, 95% CI 0.38 to 0.74, p <0.001). These findings were confirmed in a propensity score-matched population. In conclusion, treatment with ACEI was associated with better 5-year survival after AMI.
AB - Few studies have investigated whether angiotensin II receptor blocker (ARB) is a practical alternative to angiotensin-converting enzyme inhibitor (ACEI) for long-term use after acute myocardial infarction (AMI) in real-world practice in the percutaneous coronary intervention era. We compared 5-year survival benefits of ACEI and ARB in patients with AMI registered in the Osaka Acute Coronary Insufficiency Study. Study subjects were divided into 3 groups: ACEI (n = 4,425), ARB (n = 2,158), or patients without either drug (n = 2,442). A total of 661 deaths were recorded. Cox regression analysis revealed that treatment with either ACEI or ARB was associated with reduced 5-year mortality (adjusted hazard ratio [HR] 0.70, 95% confidence interval [CI] 0.58 to 0.83, p <0.001 and HR 0.79, 95% CI 0.64 to 0.98, p = 0.03, respectively). However, Kaplan-Meier estimates and Cox regression analyses based on propensity score revealed that ACEI was associated with better survival than ARB from 2 to 5 years after survival discharge (adjusted HR 0.53, 95% CI 0.38 to 0.74, p <0.001). These findings were confirmed in a propensity score-matched population. In conclusion, treatment with ACEI was associated with better 5-year survival after AMI.
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U2 - 10.1016/j.amjcard.2014.03.055
DO - 10.1016/j.amjcard.2014.03.055
M3 - Article
C2 - 24819900
AN - SCOPUS:84902299898
VL - 114
SP - 1
EP - 8
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 1
ER -