In patients with high Killip grade AMI, treatment with BB + ACEI significantly reduced the risk of major adverse cardiac events compared to BB + ARB (HR 0.574; 95% CI 0.421-0.783; p<0.001).
Cohort (n=871)
Yes
Does treatment with BB + ACEI reduce mortality and MACE compared to BB + ARB in patients with high Killip grade AMI?
In patients with high Killip grade AMI, treatment with BB + ACEI was associated with significantly lower risks of MACE, all-cause mortality, and non-cardiac death compared to BB + ARB at 3 years.
Effect estimate: HR 0.574 (95% CI 0.421-0.783)
p-value: p=<0.001
Objective This study evaluates the 3-year clinical outcomes of high Killip grade (III/IV) acute myocardial infarction (AMI) patients treated with either β-blockers (BB) and angiotensin-converting enzyme inhibitors (ACEI) or BB and angiotensin receptor blockers (ARB). Methods A total of 13,105 patients were registered at the Korea Acute Myocardial Infarction Registry at the National Institute of Health (KAMIR-NIH). Among them, 871 patients with high Killip classification AMI were divided into the BB + ACEI group (n = 489) and the BB + ARB group (n = 381). Following propensity score matching, 343 patients were selected in each group. All patients completed a 3-year follow-up period. Results The results indicate no significant differences between the BB + ACEI group and BB + ARB group in terms of cardiac death, recurrent myocardial infarction, and the rate of repeat percutaneous coronary intervention. However, the BB + ACEI group exhibited significantly lower risks in major adverse cardiac events (HR = 0.574, 95% CI: 0.421–0.783, p < .001), all-cause mortality (HR = 0.561, 95% CI: 0.404–0.778, p = .001), and non-cardiac death (HR = 0.365, 95% CI: 0.208–0.639, p < .001) compared to the BB + ARB group. Conclusion Our results suggest that BB + ACEI treatment is more beneficial than BB + ARB for high Killip grade AMI patients. Additionally, the BB + ACEI group has a superior preventative effect on mortality compared to the BB + ARB group.
Sun et al. (Mon,) conducted a cohort in High Killip grade (III/IV) acute myocardial infarction (n=871). β-blockers and ACE inhibitors (BB + ACEI) vs. β-blockers and ARBs (BB + ARB) was evaluated on Major adverse cardiac events (HR 0.574, 95% CI 0.421-0.783, p=<0.001). In patients with high Killip grade AMI, treatment with BB + ACEI significantly reduced the risk of major adverse cardiac events compared to BB + ARB (HR 0.574; 95% CI 0.421-0.783; p<0.001).
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