Key result
Beta-blockers plus ACEI linked to lower MACE and revascularization versus ARB in post-PCI NSTEMI.
Why the study?
Limited comparative data exist comparing major clinical outcomes between beta-blockers with ACE inhibitors versus beta-blockers with ARBs in patients with NSTEMI after PCI with drug-eluting stents.
Does the combination of beta-blockers with ACEI reduce major adverse cardiac events compared to beta-blockers with ARB in patients with NSTEMI after PCI with DES?
Observational (n=3,688)
Does the combination of beta-blockers with ACEI reduce major adverse cardiac events compared to beta-blockers with ARB in patients with NSTEMI after PCI with DES?
p-value: p=0.007
In patients with NSTEMI undergoing PCI with DES, the combination of beta-blockers with ACEI may be more beneficial than beta-blockers with ARB for reducing MACE and revascularization rates at 2 years.
Beta-blockers with ACEI may reduce MACE versus ARB after NSTEMI PCI; leaves open confirmation in randomized trials.
BACKGROUND: Because limited comparative data are available, we decided to compare 2-year major clinical outcomes between beta-blockers (BB) with angiotensin converting enzyme inhibitors (ACEI) and BB with angiotensin receptor blockers (ARB) therapy in patients with non-ST-segment elevation myocardial infarction (NSTEMI) after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). METHODS: = 3688). The major clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), total revascularization [target lesion revascularization (TLR), target vessel revascularization (TVR), non-TVR] rate during the 2-year follow-up period. RESULTS: = 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 TVR rather than the BB with ARB after PCI with DES in NSTEMI patients.
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Kim et al. (2019) conducted an observational in NSTEMI after PCI with DES (n=3,688). Beta-blockers with ACEI vs. Beta-blockers with ARB was evaluated on Major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction, total revascularization rate (p=0.007). Beta-blockers combined with ACEI significantly reduced the cumulative incidences of MACE, total revascularization, and TVR compared to beta-blockers with ARB in NSTEMI patients after PCI (P=0.007).
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