Clinical impacts of inhibition of renin–angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention

Hyukjin, Park; Kim, Hyun Kuk; Jeong, Myung Ho; Cho, Jae Yeong; Lee, Ki Hong; Sim, Doo Sun; Yoon, Nam Sik; Yoon, Hyun Ju; Hong, Young Joon; Kim, Kye Hun; Kim, Ju Han; Ahn, Youngkeun; Cho, Jeong Gwan; Park, Jong Chun; Kim, Young Jo; Cho, Myeong Chan; Kim, Chong Jim; Kim, Chong Jin; Kim, Jong Hyun; Chae, Shung Chull; Hur, Seung Ho; Seong, In Whan; Hong, Taek Jong; Choi, Donghoon; Chae, Jei Keon; Rhew, Jae Young; Kim, Doo Il; Chae, In Ho; Yoon, Jung Han; Koo, Bon Kwon; Kim, Byung Ok; Lee, Myoung Yong; Kim, Kee Sik; Hwang, Jin Yong; Oh, Seok; Lee, Nae Hee; Jeong, Kyoung Tae; Tahk, Seung Jea; Bae, Jang Ho; Rha, Seung Woon; Park, Keum Soo; Han, Kyoo Rok; Ahn, Tae Hoon; Kim, Moo Hyun; Yang, Joo Young; Rhim, Chong Yun; Gwon, Hyeon Cheol; Park, Seong Wook; Koh, Young Youp; Joo, Seung Jae; Kim, Soo–Joong; Jin, Dong Kyu; Cho, Jin Man; Chung, Wook Sung; Jang, Yang Soo; Seung, Ki Bae; Park, Seung Jung

doi:10.1016/j.jjcc.2016.03.012

Cited by 12 publications

(9 citation statements)

References 27 publications

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“…Use of an angiotensin converting enzyme inhibitor or an angiotensin receptor blocker is encouraged in both heart failure and MI patients according to current guidelines because of their beneficial effects against several of the harmful effects of RAAS, including tissue fibrosis, cell apoptosis, cardiac remodeling, fluid and sodium accumulation, and inflammation 6151617. Our group recently reported the beneficial effects of RAAS inhibition on cardiac function, structure, and clinical event-free survival in a large number of latecomer patients with MI in the Korea Acute Myocardial Infarction Registry, whose myocardial salvage and recovery by percutaneous coronary intervention are not expected to be highly effective: RAAS inhibition is even more important in this subset of the population 18. Fimasartan has been proven to have potent antihypertensive effects and already has been used as an AT1 receptor blocker for several years,1920 but its cardioprotective effect for MI or other types of heart failure has not yet clearly been defined.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Effect of Fimasartan in a Rat Model of Myocardial Infarction Evaluated by Cardiac Positron Emission Tomography with [¹⁸F]FPTP

et al. 2019

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We evaluated the efficacy of fimasartan on perfusion defects and infarction size in an animal model of myocardial infarction (MI), with echocardiography and positron emission tomography (PET) using a 18 F-labeled phosphonium cation (5-[ 18 F]-fluoropentyl-triphenylphosphonium salt, [ 18 F]FPTP) as a mitochondrial voltage sensor for myocardial imaging. We induced MI in 33 rats by ligation of the left coronary artery, and checked their cardiac PET image using [ 18 F]FPTP for evaluation of myocardial perfusion. Rats were grouped into 3 groups according to their administered drugs: no drug (n=11), fimasartan 3 mg/kg (n=10), and fimasartan 10 mg/kg (n=12). Each designated drug was administered for 4 weeks, and follow-up PET and histologic examinations were done. In the PET analysis, a perfusion defect size was markedly improved in fimasartan 10 mg/kg group (35.9±7.0% to 28.4±6.9%, p<0.001), whereas treatment with fimasartan 3 mg/kg induced only an insignificant reduction of perfusion defect size (35.9±7.9% to 33.9±7.3%, p=0.095). Using 2, 3, 5-triphenyltetrazolium chloride staining, infarction size was the largest in the control group (36.5±8.3%), and was insignificantly lower in the fimasartan 3 mg/kg group (31.5±6.5%, p for the difference between the control group=0.146) and was significantly lower in the fimasartan 10 mg/kg group (26.3±7.6%, p for the difference between the control group=0.011). PET imaging using a 18 F-labeled mitochondrial voltage sensor, [ 18 F]FPTP, is useful in evaluation and monitoring of myocardial perfusion states, and treatment with fimasartan decreases the infarction size in animal MI model.

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Section: Discussionmentioning

confidence: 99%

Therapeutic Effect of Fimasartan in a Rat Model of Myocardial Infarction Evaluated by Cardiac Positron Emission Tomography with [¹⁸F]FPTP

et al. 2019

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“…-Five studies that identified themselves as RCT and eight other studies that identified themselves as clinical trials [7][8][9][10][11][12][13][14][15][16][17][18][19].…”

Section: : Total Number Of Articles After Applying Inclusion/exclusimentioning

confidence: 99%

Major Adverse Cardiovascular Events: An Inevitable Outcome of ST-elevation myocardial infarction? A Literature Review

Poudel¹,

Tejpal²,

Rashid³

et al. 2019

Cureus

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Major adverse cardiovascular events (MACE) remain the major cause of mortality and morbidity in patients with STEMI (ST-elevation myocardial infarction). The current literature is aimed to analyze the occurrence of MACE following STEMI irrespective of treatment provided, and follow up after the first diagnosis of STEMI. A PubMed search for Studies of STEMI identified 24,244 articles. After applying our inclusion/exclusion criteria, we found out 75 articles of relevance wherein MACE and its components were considered to be the primary endpoint. These 75 articles included eight Cohort Studies, 13 clinical trials including five randomized controlled trials (RCT), one case-control Study, one cross-sectional study, one review article, and 51 other observational studies. Our analysis shows that MACE remains one of the strongest adverse outcomes among STEMI patients. The current literature review found out the incidence of MACE was 4.2 % to 51% irrespective of the mode of treatment, and follow-ups lasting up to 10 years from the time of STEMI diagnosis.

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“… 45) Use of a renin-angiotensin system inhibitor in STEMI patients undergoing late PCI reduced the 1-year MACE, even in low-risk patients with relatively preserved left ventricular systolic function. 46) …”

Section: Medical Treatmentmentioning

confidence: 99%

Differences in the Korea Acute Myocardial Infarction Registry Compared with Western Registries

Sim

Cho

2017

Korean Circ J

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The Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide registry that reflects current therapeutic approaches and acute myocardial infarction (AMI) management in Korea. The results of the KAMIR demonstrated different risk factors and responses to medical and interventional treatments. The results indicated that the incidence of ST-elevation myocardial infarction (STEMI) was relatively high, and that the prevalence of dyslipidemia was relatively low with higher triglyceride and lower high-density lipoprotein cholesterol levels. Percutaneous coronary intervention (PCI) rates were high for both STEMI and non-ST-elevation myocardial infarction (NSTEMI) with higher use of drug-eluting stents (DESs). DES were effective and safe without increased risk of stent thrombosis in Korean AMI patients. Triple antiplatelet therapy, consisting of aspirin, clopidogrel, and cilostazol, was effective in preventing adverse clinical outcomes after PCI. Statin therapy was effective in Korean AMI patients, including those with very low levels of low-density lipoprotein cholesterol and those with cardiogenic shock. The KAMIR score had a greater predictive value than Thrombolysis in Myocardial Infarction (TIMI) and Global Registry of Acute Coronary Events (GRACE) scores for long-term mortality in AMI patients. Based on these results, the KAMIR will be instrumental for establishing new therapeutic strategies and effective methods for secondary prevention of AMI and guidelines for Asian patients.

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Clinical impacts of inhibition of renin–angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention

Abstract: In latecomers with STEMI, RAS inhibition improved long-term clinical outcomes after a successful PCI, even in patients with low risk who had relatively preserved LVEF.

Cited by 12 publications

References 27 publications

Therapeutic Effect of Fimasartan in a Rat Model of Myocardial Infarction Evaluated by Cardiac Positron Emission Tomography with [¹⁸F]FPTP

Therapeutic Effect of Fimasartan in a Rat Model of Myocardial Infarction Evaluated by Cardiac Positron Emission Tomography with [¹⁸F]FPTP

Major Adverse Cardiovascular Events: An Inevitable Outcome of ST-elevation myocardial infarction? A Literature Review

Differences in the Korea Acute Myocardial Infarction Registry Compared with Western Registries

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Clinical impacts of inhibition of renin–angiotensin system in patients with acute ST-segment elevation myocardial infarction who underwent successful late percutaneous coronary intervention

Abstract: In latecomers with STEMI, RAS inhibition improved long-term clinical outcomes after a successful PCI, even in patients with low risk who had relatively preserved LVEF.

Cited by 12 publications

References 27 publications

Therapeutic Effect of Fimasartan in a Rat Model of Myocardial Infarction Evaluated by Cardiac Positron Emission Tomography with [18F]FPTP

Therapeutic Effect of Fimasartan in a Rat Model of Myocardial Infarction Evaluated by Cardiac Positron Emission Tomography with [18F]FPTP

Major Adverse Cardiovascular Events: An Inevitable Outcome of ST-elevation myocardial infarction? A Literature Review

Differences in the Korea Acute Myocardial Infarction Registry Compared with Western Registries

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Therapeutic Effect of Fimasartan in a Rat Model of Myocardial Infarction Evaluated by Cardiac Positron Emission Tomography with [¹⁸F]FPTP

Therapeutic Effect of Fimasartan in a Rat Model of Myocardial Infarction Evaluated by Cardiac Positron Emission Tomography with [¹⁸F]FPTP