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Effect of renin-angiotensin system inhibitors on long-term survival in patients treated with beta blockers and antiplatelet agents after acute mocardial infarction (from the MONICA/KORA Myocardial Infarction Registry).
Am. J. Cardiol. 114, 329-335 (2014)
Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have shown to decrease mortality and cardiovascular morbidity especially in high-risk patients after acute myocardial infarction (AMI). Aim of this study was to assess the association between ACEI or ARB treatment (ACEI/ARB) at hospital discharge and long-term survival after AMI in real-life patient care. From a German population-based AMI registry, 3,544 patients (75.4% men), aged 28 to 74 years, hospitalized with an incident AMI between 2000 and 2008, surviving at least 24 hours and treated with β blockers and antiplatelet agents at discharge were included in this study. All data were collected by standardized interviews and chart review. End point of this study was all-cause mortality at 3 follow-up periods: 1, 3, and 5 years after AMI. Mortality was assessed for all registered patients in 2010. Survival analyses and multivariable Cox regression analyses were conducted. Of the 3,544 patients, 83.7% received ACEI/ARB and 90.1% were treated with statins at hospital discharge. During a median follow-up period of 5.0 years (interquartile range 1.0 years), 9.3% patients died. In the multivariable Cox models adjusting for a number of covariates, use of ACEI/ARB showed a significantly inverse relation with 1-, 3-, and 5-year mortality (e.g., 5-year mortality: hazard ratio 0.74, 95% confidence interval 0.59 to 0.94, p = 0.015), and the hazard ratios for mortality did not differ significantly between the 3 examined follow-up periods. In conclusion, use of ACEI/ARB at hospital discharge is independently associated with long-term survival benefit in patients with incident AMI already treated with other guideline-recommended cardiovascular drugs.
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Publication type
Article: Journal article
Document type
Scientific Article
Keywords
Coronary-artery-disease; Secondary Prevention; Heart-association; Task-force; Therapy; Guidelines; Reduction; Outcomes; Failure; Risk
ISSN (print) / ISBN
0002-9149
e-ISSN
1879-1913
Quellenangaben
Volume: 114,
Issue: 3,
Pages: 329-335
Publisher
Elsevier
Publishing Place
Bridgewater
Non-patent literature
Publications
Reviewing status
Peer reviewed
Institute(s)
Institute of Epidemiology II (EPI2)