Comparison of 5-year survival after acute myocardial infarction using angiotensin-converting enzyme inhibitor versus angiotensin ii receptor blocker

Masahiko Hara, Yasuhiko Sakata, Daisaku Nakatani, Shinichiro Suna, Masaya Usami, Sen Matsumoto, Toshifumi Sugitani, Masami Nishino, Hiroshi Sato, Tetsuhisa Kitamura, Shinsuke Nanto, Toshimitsu Hamasaki, Masatsugu Hori, Issei Komuro

Research output: Contribution to journalArticlepeer-review

19 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalAmerican Journal of Cardiology
Volume114
Issue number1
DOIs
Publication statusPublished - 2014 Jul 1

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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