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.