Real-world use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers/β-blocks in Chinese patients before acute myocardial infarction occurs: patient characteristics and hospital follow-up.

BACKGROUND

Current guidelines recommend angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB) or β-blockers (β-B) for secondary prevention in patients after an acute myocardial infarction (AMI). However, there is limited data to evaluate ACEI/ARB/β-B (AAβ) used before AMI on major adverse cardiovascular events (MACE), in China patients.

OBJECTIVES

This study sought to investigate whether AAβ treatment prior to AMI is associated with better hospital outcomes at the onset of AMI.

METHODS

A total of 2705 patients were selected from the Cardiovascular Center Beijing Friendship Hospital Database Bank, and divided into two groups on the basis of admission prescription: AAβ (n = 872) or no-AAβ (n = 1833). The study was also designed using propensity-score matching (226 AAβ treated patients vs 452 no-AAβ treated patients). The primary outcome was a composite of cardiac death and heart function and infarct size during hospitalization follow-up.

RESULTS

The mean follow-up period was about 8 days in MACE. The Cox model showed the two groups had similar risk of cardiac death. The in-hospital mortality was 3.36% (3.33% of AAβ users and 3.38% of nonusers, p = 0.94). In adjusted analysis, there was still no difference in in-hospital mortality between the two groups (3.54% vs 2.88%, p = 0.64). However, the AAβ treated patients were associated with better heart function and smaller infarct size than the no-AAβ treated patients.

CONCLUSIONS

The in-hospital MACE was similar between AAβ treated patients and no-AAβ treated patients. However, treatment with AAβ before AMI was associated with improved heart function and smaller infarct size.