Key result
ACEIs linked to fewer major events than ARBs in AMI patients with renal impairment.
Why the study?
To compare the clinical outcomes of patients with acute myocardial infarction with renal impairment treated with ACEIs versus ARBs in real-world clinical settings.
Does treatment with ACEIs improve major adverse cardiac and cerebrovascular events compared to ARBs in patients with acute myocardial infarction and renal impairment?
Cohort (n=4,790)
Does treatment with ACEIs improve major adverse cardiac and cerebrovascular events compared to ARBs in patients with acute myocardial infarction and renal impairment?
In a real-world cohort of patients with acute myocardial infarction and renal impairment, ACEIs appeared to provide greater cardiovascular benefit than ARBs.
ACEIs may be associated with fewer events than ARBs in acute MI with renal impairment; hypothesis-generating and should not yet change practice.
OBJECTIVE: To compare the clinical outcomes of patients with acute myocardial infarction with renal impairment (AMI-RI) treated with either angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) in real-world clinical settings. PATIENTS AND METHODS: A total of 4790 consecutive patients with AMI-RI between November 1, 2011, and December 31, 2015, were subdivided into ACEI (n=2845) and ARB (n=1945) treatment groups. The primary end points were major adverse cardiac and cerebrovascular events, including all-cause mortality, nonfatal myocardial infarction, any revascularization, cerebrovascular accident, rehospitalization, and stent thrombosis. Propensity score matching (PSM) was used to adjust for group differences. RESULTS: in the PSM-adjusted analysis. CONCLUSION: Treatment with ACEIs seemed to be more beneficial than treatment with ARBs for patients with AMI-RI; further prospective studies are required to confirm these results.
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Oh et al. (2023) conducted a cohort in Acute myocardial infarction with renal impairment (AMI-RI) (n=4,790). Angiotensin-converting enzyme inhibitors (ACEIs) vs. Angiotensin receptor blockers (ARBs) was evaluated on Major adverse cardiac and cerebrovascular events (including all-cause mortality, nonfatal myocardial infarction, any revascularization, cerebrovascular accident, rehospitalization, and stent thrombosis). Treatment with ACEIs seemed to be more beneficial than ARBs for major adverse cardiac and cerebrovascular events in a cohort of 4790 patients with acute myocardial infarction and renal impairment.
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