The Beneficial Effects of Renin-Angiotensin System Blockades on 2 Year Outcomes in Coronary Artery Ectasia Patients

Curr Med Res Opin. 2017 Sep;33(9):1677-1684. doi: 10.1080/03007995.2017.1340879. Epub 2017 Jun 25.

Abstract

Objectives: This study was designed to investigate the impact of renin-angiotensin system blockade (RASB) therapy with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers on the outcomes of coronary artery ectasia (CAE).

Methods: The CAE patients identified by coronary angiography from our center were consecutively enrolled. We obtained the baseline discharge prescription of RASB from the medical records system and conducted follow-up through telephone interviews. Cox regression models, propensity score and subgroup analysis were used to assess the impact of RASB on all-cause mortality and non-fatal myocardial infarction. Both the unadjusted and adjusted Kaplan-Meier curves stratified by RASB therapy were plotted.

Results: There were 595 patients with CAE in total and 333 (56.0%) were prescribed RASB therapy. Over a 2 year follow-up time, 16 all-cause deaths and 10 non-fatal myocardial infarctions were identified. Those patients treated with RASB had a significantly lower all-cause mortality and non-fatal myocardial infarction rate with an adjusted hazard ratio of 0.32 (95% confidence interval: 0.13 to 0.77, p = .011). The outcome benefits of RASB therapy were further confirmed in the propensity score analysis and subgroup analysis.

Conclusions: This observational study suggests that RASB therapy is associated with a lower risk of all-cause mortality and non-fatal myocardial infarction in patients with CAE.

Keywords: Coronary artery ectasia; angiotensin receptor antagonists; angiotensin-converting enzyme inhibitors; renin angiotensin system; treatment outcomes.

MeSH terms

  • Aged
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Coronary Vessels / drug effects*
  • Dilatation, Pathologic / drug therapy
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / epidemiology
  • Myocardial Infarction / mortality
  • Patient Discharge
  • Propensity Score
  • Proportional Hazards Models
  • Renin-Angiotensin System / drug effects*
  • Retrospective Studies
  • Risk
  • Treatment Outcome

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors