Additive effects of ß-blockers on renin-angiotensin system inhibitors for patients after acute myocardial infarction treated with primary coronary revascularization.
Circ J
; 75(8): 1982-91, 2011.
Article
en En
| MEDLINE
| ID: mdl-21697605
ABSTRACT
BACKGROUND:
Although some ß-blockers are effective for patients after acute myocardial infarction (AMI), few studies have compared their additive effects on renin-angiotensin system inhibitors (RAS-Is). METHODS ANDRESULTS:
The 251 consecutive AMI patients administered angiotensin-converting-enzyme inhibitors (ACE-Is) or angiotensin-II receptor blockers (ARBs) were retrospectively investigated and divided into 2 groups treated without ß-blockers (no-ß-blocker group, n=80) or treated with ß-blockers before discharge (ß-blocker group, n=171; carvedilol [n=91] or bisoprolol [n=80]). The doses of RAS-Is used for patients in the no-ß-blocker group were at least double those used in the ß-blocker group. No significant differences between the 2 groups were observed with regard to baseline characteristics. After a 12-month follow-up, the survival and cardiac event-free rates in the ß-blocker group were significantly higher than those in the no-ß-blocker group. The percent change in blood pressure did not significantly differ between the 2 groups, but the levels of brain natriuretic peptide, metalloproteinase-2, and metalloproteinase-9 and the left ventricular ejection fraction improved significantly in the ß-blocker group compared with the no-ß-blocker group. Regarding the 2 ß-blockers, carvedilol treatment produced more favorable outcomes than bisoprolol.CONCLUSIONS:
The data suggest that treatment with RAS-I in combination with ß-blocker is more effective for patients after AMI than treatment with RAS-I alone.
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Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Propanolaminas
/
Sistema Renina-Angiotensina
/
Carbazoles
/
Inhibidores de la Enzima Convertidora de Angiotensina
/
Angioplastia Coronaria con Balón
/
Bisoprolol
/
Antagonistas de Receptores de Angiotensina
/
Antagonistas de Receptores Adrenérgicos beta 1
/
Infarto del Miocardio
Tipo de estudio:
Observational_studies
/
Prognostic_studies
Límite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Circ J
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2011
Tipo del documento:
Article
País de afiliación:
Japón