Comparison of clinical outcomes of angiotensin receptor blockers with angiotensin-converting enzyme inhibitors in patients with acute myocardial infarction

Chih Wei Chen, Chun Wei Chang, Yi Cheng Lin, Wan Ting Chen, Li Nien Chien*, Chun Yao Huang*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Background Angiotensin receptor blockers (ARBs) are considered an alternative to angiotensin-converting enzyme inhibitors (ACEIs) in patients with acute myocardial infarction (AMI), but in the era of extensive use of preventive therapies and percutaneous coronary intervention, this has not been adequately evaluated in Asians. Methods This retrospective cohort study used data from the Taiwan National Health Insurance Research Database. In total, 52,620 patients initially hospitalized due to AMI between 2002 and 2015 were assessed. Results After propensity score matching, 14,993 patients each were assigned to ACEI and ARB groups. Patients who received ARBs had significantly lower all-cause mortality (adjusted hazard ratio [aHR]: 0.82; 95% confidence interval [CI]: 0.75–0.90) and hospitalization for heart failure (aHR: 0.92; 95% CI: 0.85–0.99) compared with those who received ACEIs at 18 month follow-up. No significant difference was observed between the two groups in terms of major adverse cardiovascular events (aHR: 098; 95% CI: 0.90–1.07), cardiovascular death (aHR: 0.82; 95% CI: 0.68–1.00), ischemia stroke (aHR: 0.93; 95% CI: 0.77–1.11), and nonfatal myocardial infarction (aHR: 1.04; 95% CI: 0.93–1.17). ARBs showed benefits in many subgroups in terms of all-cause mortality and cardiovascular death. Conclusions Real-world data demonstrate that ARBs might be associated with lower all-cause mortality and hospitalization for heart failure compared with ACEIs among patients with AMI.

Original languageEnglish
Article numbere0290251
JournalPLoS ONE
Volume18
Issue number9 September
DOIs
StatePublished - Sep 2023

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