Relationship between beta-blocker and angiotensin-converting enzyme inhibitor dose and clinical outcome following acute myocardial infarction

Circulation Journal : Official Journal of the Japanese Circulation Society
Sylvain GrallAlain Furber

Abstract

Benefit of β-blockers (BB) and angiotensin-converting-enzyme inhibitors (ACEI) on mortality following acute myocardial infarction (MI) is well demonstrated. This study assessed the impact of BB and ACEI doses administered following ST-elevation MI on mortality and outcome up to 1 year. METHODS AND RESULTS: The French prospective observational cohort "RIMA" included 1,461 MI patients. Dosing of BB and ACEI given at 24 h and at time of discharge was assessed as follows: no treatment; <50% of target dose; or ≥50% of target dose. For in-hospital mortality, after MI, the use of BB in the first 24 h, but not ACEI, was associated with significantly lower event rate on multivariate analysis (OR, 5.78; 95% CI: 2.62-12.76, P<0.001). In contrast at 1 year, use of higher doses of ACEI, but not BB, was associated with significantly lower CV mortality, readmission for heart failure and the composite of CV mortality and readmission for heart failure (HR, 2.65; 95% CI: 1.32-5.31, P=0.006 for absence of ACEI at discharge). Prescription of BB in the first 24 h was independently associated with a lower in-hospital mortality following MI. There appeared to be a significant dose effect on outcome with regard to <50% vs. ≥50% of target dose, which r...Continue Reading

References

Sep 25, 1990·The American Journal of Cardiology·J P BoisselT Ducruet
Mar 26, 1982·JAMA : the Journal of the American Medical Association
Sep 19, 2003·Lancet·K M Fox, UNKNOWN EURopean trial On reduction of cardiac events with Perindopril in stable coronary Artery disease Investigators
Nov 12, 2003·The New England Journal of Medicine·Marc A PfefferUNKNOWN Valsartan in Acute Myocardial Infarction Trial Investigators
Nov 8, 2005·Lancet·Z M ChenUNKNOWN COMMIT (ClOpidogrel and Metoprolol in Myocardial Infarction Trial) collaborative group
Mar 17, 2009·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Kornelia KotsevaUNKNOWN EUROASPIRE Study Group
Apr 7, 2009·Circulation Journal : Official Journal of the Japanese Circulation Society·Hiroshi SuzukiTakashi Katagiri
Sep 10, 2010·American Heart Journal·Jeffrey J GoldbergerUNKNOWN PACE-MI Investigators
Mar 9, 2011·European Heart Journal·Raffaele BugiardiniUNKNOWN Canadian Acute Coronary Syndrome Registry I and II Investigators
Aug 28, 2012·European Heart Journal·UNKNOWN Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC)Doron Zahger
Dec 13, 2012·Circulation. Cardiovascular Quality and Outcomes·François SchieleCatherine Grenier
Jan 8, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Tomohiro NishinoUNKNOWN CREDO-Kyoto PCI/CABG registry cohort-2 investigators
Mar 6, 2013·Circulation Journal : Official Journal of the Japanese Circulation Society·Toshiaki ToyotaUNKNOWN Credo-Kyoto Investigators

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Citations

Mar 10, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Dipak Kotecha, Thomas G von Lueder
Feb 13, 2019·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·Chien-Ho LeeCheng-I Cheng

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