Angiotensin converting enzyme inhibitors versus angiotensin II type 1 receptor blockers in patients with acute myocardial infarction and prediabetes after successful implantation of newer-generation drug-eluting stents

Abstract

BACKGROUND: Because limited data are available, the present study investigated 2-year major clinical
outcomes after angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor
blockers (ARBs) therapy in patients with acute myocardial infarction (AMI) and prediabetes after successful
implantation of newer-generation drug-eluting stents (DESs).
METHODS: Overall, 2932 patients with AMI and prediabetes were classified into two groups — the ACEIs
group (n = 2059) and the ARBs group (n = 873). The primary endpoint was the occurrence of patient-
-oriented composite outcome (POCO), defined as all-cause death, recurrent myocardial infarction (Re-MI),
or any repeat revascularization. The secondary endpoint was definite or probable stent thrombosis (ST).
RESULTS: The cumulative incidences of POCO (adjusted hazard ratio [aHR]: 1.020; 95% confidence
interval [CI]: 0.740–1.404; p = 0.906), all-cause death (aHR: 1.394; 95% CI: 0.803–2.419; p = 0.238),
Re-MI (aHR: 1.210; 95% CI: 0.626–2.340; p = 0.570), any repeat revascularization (aHR: 1.150; 95%
CI: 0.713–1.855; p = 0.568), and ST (aHR: 1.736; 95% CI: 0.445–6.766; p = 0.427) were similar
between the groups. These results were confirmed after propensity score-adjusted analysis.
CONCLUSIONS: In this study, patients with AMI and prediabetes who received ACEIs or ARBs showed
comparable clinical outcomes during the 2-year follow-up period.