Could ARBs Benefit MI Patients As Much As ACE Inhibitors?
Taking angiotensin receptor blockers (ARBs) could benefit patients with ST-elevation myocardial infarction with preserved left ventricular systolic function just as much as angiotensin-converting-enzyme (ACE) inhibitors, according to a recent study.
In order to investigate the effects of treatment with angiotensin receptor blockers in these patients, researchers monitored 6698 participants between November 2005 and September 2010 with ST segment elevation myocardial infarction; each participant had a history of primary percutaneous coronary intervention and yielded a left ventricular ejection fraction of ≥40%.
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Researchers divided participants into 3 groups and performed a propensity score matching analysis: an angiotensin receptor blocker group (1185 participants), an ACE inhibitor group (4564 participants), and a group of 949 individuals who did not receive a renin angiotensin system blocker.
After nearly a year of follow-up, researchers found that myocardial infarction or cardiac death occurred in 21 patients from the angiotensin receptor blocker group, in 77 participants from the ACE inhibitor group, and in 33 individuals that did not receive any treatment.
After propensity score matching which included 1175 pairs of participants, researchers found that there was no major difference in myocardial infarction rate or in cardiac deaths between the ACE inhibitor group and the angiotensin receptor blocker group: 21 (1.8%) vs. 23 (2.0%).
“Angiotensin receptor blocker showed beneficial effects comparable with ACE inhibitors in patients with ST segment elevation myocardial infarction with preserved left ventricular systolic function,” they concluded. “Angiotensin receptor blockers could be used as an alternative to ACE inhibitors in such patients.”
-Michelle Canales
Reference:
1. Yang JH, Hahn JY, Song YB, et al. Angiotensin receptor blocker in patients with ST segment elevation myocardial infarction with preserved left ventricular systolic function: prospective cohort study. BMJ. 2014 November [epub ahead of print] doi: http://dx.doi.org/10.1136/bmj.g6650.