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Journal of Geriatric Cardiology, 2019. 16, 280-290, DOI: https://doi.org/10.11909/j.issn.1671-5411.2019.03.010
Long-term clinical outcome between beta-blocker with ACEI or ARB in patients with NSTEMI who underwent PCI with drug-eluting stents
Yong Hoon Kim, Ae-Young Her; Eun-Seok Shin; Myung Ho Jeong
Background: Because limited comparative data are available, we decided to compare 2-year major clinical outcomes betweenbeta-blockers (BB) with angiotensin converting enzyme inhibitors (ACEI) and BB with angiotensin receptor blockers (ARB) therapy in patientswith non-ST-segment elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI) with drug-elutingstents (DES).
Methods: A total 11,288 NSTEMI patients who underwent PCI with DES were enrolled and they were divided into twogroups, the BB with ACEI group (n = 7600) and the BB with ARB group (n = 3688). The major clinical endpoint was the occurrence ofmajor adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), total revascularization [target lesionrevascularization (TLR), target vessel revascularization (TVR), non-TVR] rate during the 2-year follow-up period.
Results: After propensity score-matched (PSM) analysis, two PSM groups (3317 pairs, n = 6634, C-statistic = 0.695) were generated. Although the cumulativeincidences of all-cause death, cardiac death, TLR, and non-TVR were similar between the two groups, MACE (HR = 0.832, 95% CI:0.7040.982, P = 0.030), total revascularization rate (HR = 0.767, 95% CI: 0.5980.984, P = 0.037), and TVR rate (HR = 0.646, 95% CI:0.4700.888, P = 0.007) were significantly lower in the BB with ACEI group after PSM.
Conclusions: In this study, we suggest that the combination of BB with ACEI may be beneficial for reducing the cumulative incidences of MACE, total revascularization rate, and TVRrather than the BB with ARB after PCI with DES in NSTEMI patients.
- DOI: https://doi.org/10.11909/j.issn.1671-5411.2019.03.010
- ISBN or ISSN: 1671-5411
- 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
- This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.