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[Effect of combined beta-blocker and angiotensin-converting enzyme inhibitor treatment on 1-year survival after acute myocardial infarction: findings of the PRIAMHO-II registry].
Rev Esp Cardiol. 2006 Apr; 59(4):313-20.RE

Abstract

INTRODUCTION AND OBJECTIVES

Clinical trials have shown that combining beta-blockers and angiotensin-converting enzyme (ACE) inhibitors has an additive effect in reducing mortality in patients with left ventricular dysfunction following acute myocardial infarction. Whether this additive effect also occurs in unselected post-myocardial infarction patients is unknown.

METHODS

In total, 5397 patients who were discharged from hospital after suffering an acute myocardial infarction were followed for 1 year. The primary endpoint was all-cause mortality. The effects of the medications on 1-year survival were analyzed using a Cox regression model, which included propensity scores for beta-blocker and ACE inhibitor use to take account of any potential imbalance in drug prescription rates.

RESULTS

At hospital discharge, 55.9% of patients were receiving beta-blockers and 45.1%, ACE inhibitors. The 1-year mortality rate was 5.5%. Overall, combination of the two medications significantly reduced the 1-year mortality rate (hazard ratio [HR]=0.51; 95% confidence interval [IC], 0.32-0.82); P<.005) to a greater extent than ACE inhibitors alone (HR=0.78; 95% CI, 0.54-1.12; P=.2) or beta-blockers alone (HR=0.67; 95% CI, 0.43-1.05; P=.08). The same trend was also observed in low-risk patients without acute heart failure who had an ejection fraction > or =40%.

CONCLUSIONS

In unselected post-myocardial infarction patients, combined prescription of beta-blockers and ACE inhibitors had an additive effect on the 1-year survival rate.

Authors+Show Affiliations

Area de Cardiología y Críticos, Hospital Txagorritxu, Vitoria, Spain. aborau@secardiologia.esNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

spa

PubMed ID

16709383

Citation

Arós, Fernando, et al. "[Effect of Combined Beta-blocker and Angiotensin-converting Enzyme Inhibitor Treatment On 1-year Survival After Acute Myocardial Infarction: Findings of the PRIAMHO-II Registry]." Revista Espanola De Cardiologia, vol. 59, no. 4, 2006, pp. 313-20.
Arós F, Loma-Osorio A, Vila J, et al. [Effect of combined beta-blocker and angiotensin-converting enzyme inhibitor treatment on 1-year survival after acute myocardial infarction: findings of the PRIAMHO-II registry]. Rev Esp Cardiol. 2006;59(4):313-20.
Arós, F., Loma-Osorio, A., Vila, J., López-Bescós, L., Cuñat, J., Rodríguez, E., San José, J. M., Heras, M., & Marrugat, J. (2006). [Effect of combined beta-blocker and angiotensin-converting enzyme inhibitor treatment on 1-year survival after acute myocardial infarction: findings of the PRIAMHO-II registry]. Revista Espanola De Cardiologia, 59(4), 313-20.
Arós F, et al. [Effect of Combined Beta-blocker and Angiotensin-converting Enzyme Inhibitor Treatment On 1-year Survival After Acute Myocardial Infarction: Findings of the PRIAMHO-II Registry]. Rev Esp Cardiol. 2006;59(4):313-20. PubMed PMID: 16709383.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Effect of combined beta-blocker and angiotensin-converting enzyme inhibitor treatment on 1-year survival after acute myocardial infarction: findings of the PRIAMHO-II registry]. AU - Arós,Fernando, AU - Loma-Osorio,Angel, AU - Vila,Joan, AU - López-Bescós,Lorenzo, AU - Cuñat,José, AU - Rodríguez,Emilio, AU - San José,José M, AU - Heras,Magda, AU - Marrugat,Jaume, AU - ,, PY - 2006/5/20/pubmed PY - 2006/8/17/medline PY - 2006/5/20/entrez SP - 313 EP - 20 JF - Revista espanola de cardiologia JO - Rev Esp Cardiol VL - 59 IS - 4 N2 - INTRODUCTION AND OBJECTIVES: Clinical trials have shown that combining beta-blockers and angiotensin-converting enzyme (ACE) inhibitors has an additive effect in reducing mortality in patients with left ventricular dysfunction following acute myocardial infarction. Whether this additive effect also occurs in unselected post-myocardial infarction patients is unknown. METHODS: In total, 5397 patients who were discharged from hospital after suffering an acute myocardial infarction were followed for 1 year. The primary endpoint was all-cause mortality. The effects of the medications on 1-year survival were analyzed using a Cox regression model, which included propensity scores for beta-blocker and ACE inhibitor use to take account of any potential imbalance in drug prescription rates. RESULTS: At hospital discharge, 55.9% of patients were receiving beta-blockers and 45.1%, ACE inhibitors. The 1-year mortality rate was 5.5%. Overall, combination of the two medications significantly reduced the 1-year mortality rate (hazard ratio [HR]=0.51; 95% confidence interval [IC], 0.32-0.82); P<.005) to a greater extent than ACE inhibitors alone (HR=0.78; 95% CI, 0.54-1.12; P=.2) or beta-blockers alone (HR=0.67; 95% CI, 0.43-1.05; P=.08). The same trend was also observed in low-risk patients without acute heart failure who had an ejection fraction > or =40%. CONCLUSIONS: In unselected post-myocardial infarction patients, combined prescription of beta-blockers and ACE inhibitors had an additive effect on the 1-year survival rate. SN - 0300-8932 UR - https://www.unboundmedicine.com/medline/citation/16709383/[Effect_of_combined_beta_blocker_and_angiotensin_converting_enzyme_inhibitor_treatment_on_1_year_survival_after_acute_myocardial_infarction:_findings_of_the_PRIAMHO_II_registry]_ L2 - http://www.revespcardiol.org/en/linksolver/ft/ivp/1579-2242/59/313 DB - PRIME DP - Unbound Medicine ER -