Details

Autor(en) / Beteiligte

• Chen, Ruth W
• Zheng, Huili
• Hausenloy, Derek
• Sahlen, Anders
• Tan, Jack W
• Chua, Terrance S
• Tan, Huay-Cheem
• Yeo, Tiong-Cheng
• Ho, Hee-Hwa
• Tong, Khim-Leng
• Foo, Ling-Li
• Richards, A Mark
• Chan, Mark Y

Titel

Abstract 15780: Relation Between Discharge Pharmacotherapies and One-Year Heart Failure Rehospitalization in Nationwide Study of 35,192 Patients With Acute Myocardial Infarction

Ist Teil von

• Circulation (New York, N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A15780-A15780

Ort / Verlag

by the American College of Cardiology Foundation and the American Heart Association, Inc

Erscheinungsjahr

2018

Link zum Volltext

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• IntroductionThere are few data investigating the impact of angiotensin converting enzyme inhibitor/angiotensin receptor blocker (ACEI/ARB) and beta-blocker use on long-term heart failure (HF) outcomes in AMI.MethodsState legislature mandates that all patients hospitalized for AMI enter the Singapore MI Registry. Heart failure rehospitalization is ascertained through linkage with the national Death and Mediclaims Registries. In multivariable analysis accounting for age, sex, race, prior diabetes, prior hypertension, prior hyperlipidemia, prior MI/PCI/CABG, smoking status, troponin level, renal function, Killip class and left ventricular ejection fraction (LVEF), we investigated the association between discharge use of ACEI/ARB and beta-blockers with one-year HF rehospitalization episodes. Mortality was modelled as a competing risk.ResultsFrom 2007-2013, there were 22,641 non-STEMI and 12,551 STEMI cases in Singapore (population ~5.5 million). High rates of pre-discharge revascularization were observed in both non-STEMI and STEMI patients, exceeding 50% and 70% respectively (Table). Discharge ACEI/ARB exceeded 65% and 70% respectively for non-STEMI and STEMI while discharge beta-blocker use exceeded 80% for both groups. The adjusted hazard ratio for one-year HF rehospitalization was 0.90 (95% confidence interval 0.82-0.99, P=0.030) for ACEI/ARB and 1.01 (95% confidence interval 0.90-1.14, P=0.840) for beta-blockers.ConclusionIn a contemporary AMI population managed aggressively with inhospital revascularization, discharge use of ACEI/ARB was associated with a reduction in one-year HF rehospitalization while discharge beta-blocker use was not.