METHODS: A total of 13,105 patients were registered at the Korea Acute Myocardial Infarction Registry at the National Institute of Health (KAMIR-NIH). Among them, 871 patients with high Killip classification AMI were divided into the BB + ACEI group (n = 489) and the BB + ARB group (n = 381). Following propensity score matching, 343 patients were selected in each group. All patients completed a 3-year follow-up period.
RESULTS: The results indicate no significant differences between the BB + ACEI group and BB + ARB group in terms of cardiac death, recurrent myocardial infarction, and the rate of repeat percutaneous coronary intervention. However, the BB + ACEI group exhibited significantly lower risks in major adverse cardiac events (HR = 0.574, 95% CI: 0.421-0.783, p < .001), all-cause mortality (HR = 0.561, 95% CI: 0.404-0.778, p = .001), and non-cardiac death (HR = 0.365, 95% CI: 0.208-0.639, p < .001) compared to the BB + ARB group.
CONCLUSIONS: Our results suggest that BB + ACEI treatment is more beneficial than BB + ARB for high Killip grade AMI patients. Additionally, the BB + ACEI group has a superior preventative effect on mortality compared to the BB + ARB group.
方法:共有13,105名患者在国立卫生研究院(KAMIR-NIH)的韩国急性心肌梗死登记处登记。其中,将871例高Killip分级AMI患者分为BB+ACEI组(n=489)和BB+ARB组(n=381)。在倾向得分匹配之后,每组抽取343例患者。所有患者均完成3年随访。
结果:结果表明BB+ACEI组和BB+ARB组在心源性死亡方面没有显著差异,复发性心肌梗死,和重复经皮冠状动脉介入治疗的比率。然而,BB+ACEI组主要不良心脏事件的风险显著降低(HR=0.574,95%CI:0.421-0.783,p<.001),全因死亡率(HR=0.561,95%CI:0.404-0.778,p=.001),与BB+ARB组相比,非心源性死亡(HR=0.365,95%CI:0.208-0.639,p<.001)。
结论:我们的结果表明,对于高Killip级AMI患者,BB+ACEI治疗比BB+ARB更有益。此外,与BB+ARB组相比,BB+ACEI组对死亡率具有更好的预防作用。