Effect of Beta Blockers and Renin-Angiotensin System Inhibitors on Survival in Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention.

ABSTRACT: Because it remains uncertain whether ?-blockers (BBs) and/or renin-angiotensin system inhibitors benefit a broad population of acute myocardial infarction (AMI) patients, we sought to evaluate the effectiveness of these drugs in improving survival for post-AMI patients who underwent a percutaneous coronary intervention (PCI).From the nationwide data of the South Korea National Health Insurance, 33,390 patients with a diagnosis of AMI who underwent a PCI between 2009 and 2013 and survived at least 30 days were included in this study. We evaluated the risk of all-cause death for patients treated with both BB and angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor antagonist (ARB) (n?=?16,280), only BB (n?=?3683), and only ACEI/ARB (n?=?9849), with the drug-untreated patients (n?=?3578) as the reference.Over a median follow-up of 2.4 years, although treated patients displayed a trend toward improved survival, there were no significant differences in the adjusted risk of all-cause death when patients were treated with both drugs (hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.70-1.06, P?=?0.154), BB (HR 0.88, 95% CI 0.68-1.14, P?=?0.325), or ACEI/ARB (HR 0.84, 95% CI 0.68-1.04, P?=?0.111). No additional benefit was found for the combination therapy compared with either isolated BB (HR 0.98, 95% CI 0.80-1.21, P?=?0.856) or ACEI/ARB (HR 1.03, 95% CI 0.89-1.19, P?=?0.727) therapy.Treatment with BB and/or ACEI/ARB has limited effect on survival in unselected nonfatal AMI patients who undergo PCI.

SUBMITTER: Lee PH 

PROVIDER: S-EPMC4998883 | biostudies-other | 2016 Mar

REPOSITORIES: biostudies-other