Effect of Secondary Prevention Medication on the Prognosis in Patients With Myocardial Infarction With Nonobstructive Coronary Artery Disease.
J Cardiovasc Pharmacol
; 76(6): 678-683, 2020 12.
Article
em En
| MEDLINE
| ID: mdl-33284169
ABSTRACT
Myocardial infarction with nonobstructive coronary arteries (MINOCA) has been and remained a puzzling clinical entity. The role of secondary prevention therapy in patients with MINOCA remains unclear. This study aimed to evaluate the associations between secondary prevention medications and outcomes in patients with MINOCA. A total of 259 patients with MINOCA were consecutively enrolled. Basic information and medication of patients were assessed. We defined major adverse cardiovascular events as the primary end point and angina rehospitalization as the secondary end point. Logistic regression models were used to assess the correlation between treatment and outcomes. The proportion of statins, aspirin, clopidogrel, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB), and ß-blocker used at admission was 88.8%, 86.9%, 84.6%, 51.7%, and 61.4%, respectively. At discharge, patients with MINOCA were less likely to be released on statins, aspirin, clopidogrel, ACEI/ARB, and ß-blocker. The use of secondary prevention medications was significantly lower at 2 years of follow-up with the most significant reductions being clopidogrel 29.4%, ACEI/ARB 39.0%, and aspirin 42.3%. About 19.1% of patients with MINOCA suffered adverse events during the follow-up period. Adverse events risk decreased when statins and ACEI/ARB were used, whereas the risk of adverse events was not lower in patients with aspirin, clopidogrel, and ß-blocker. In conclusion, patients with MINOCA were less likely to receive secondary prevention medications at the time of discharge and early discontinuation of medications at the time of follow-up. Statins and ACEI/ARB were the only medications substantially associated with lower adverse events; by comparison, aspirin, clopidogrel, and ß-blocker seem to have no impact on prognosis.
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Base de dados:
MEDLINE
Assunto principal:
Doença da Artéria Coronariana
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Inibidores da Enzima Conversora de Angiotensina
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Inibidores da Agregação Plaquetária
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Antagonistas Adrenérgicos
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Inibidores de Hidroximetilglutaril-CoA Redutases
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Prevenção Secundária
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Antagonistas de Receptores de Angiotensina
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Infarto do Miocárdio com Supradesnível do Segmento ST
Idioma:
En
Ano de publicação:
2020
Tipo de documento:
Article