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ACE inhibitors, angiotensin receptor blockers reduce HF readmission after acute MI discharge

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CHICAGO — Patients with reduced left ventricular ejection fraction who were discharged after being hospitalized for acute MI and took ACE inhibitors or angiotensin receptor blockers had decreased risk for HF readmissions, according to data presented at the American Heart Association Scientific Sessions.

Sergio Raposeiras-Roubín, MD, PhD, a clinical cardiologist at the University Hospital Alvaro Cunqueiro in Vigo, Spain, and colleagues analyzed data from 8,169 patients who were discharged with acute MI from two university hospitals in Spain between 2010 and 2016. A propensity score matching analysis was performed based on who was being treated with ACE inhibitors or angiotensin receptor blockers, which resulted in two paired groups of 1,786 patients each.

The endpoint was HF admissions during a median of 2.9 years of follow-up.

During the study period, 14.8% of patients died and 14.9% were admitted to the hospital for HF.

The cumulative incidence function for patients with HF was 5.2 per 100 persons per year (95% CI, 4.9-5.5). This was higher in patients with LVEF 40% compared with those with LVEF above 40% (12.4 per 100 patients per year vs. 4.2 per 100 patients per year).

Patients who were taking ACE inhibitors or angiotensin receptor blockers did not have a lower risk for HF readmission (sub-HR = 1.09; 95% CI, 0.96-1.23).

In the propensity-score matching analysis, patients treated with ACE inhibitors or angiotensin receptor blockers did not have fewer HF readmissions (sub-HR = 1.01; 95% CI, 0.85-1.19). When analyzed by LVEF, patients treated with either therapy had reduced risk for HF readmissions as LVEF decreased. Significant differences were seen in patients with LVEF 40% (sub-HR = 0.65; 95% CI, 0.46-0.92). – by Darlene Dobkowski

Reference:

Raposeiras-Roubín S, et al. Session CS.APS.01 – Outcomes Potpourri. Presented at: American Heart Association Scientific Sessions; Nov. 10-12, 2018; Chicago.

Disclosures: The authors report no relevant financial disclosures.