Timing of RAS blocker administration and long-term cardiovascular outcomes in STEMI patients.

IF 1.1 4区 医学 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS
Herz Pub Date : 2025-06-16 DOI:10.1007/s00059-025-05317-x
Tuğba Çetin, Mehmet Baran Karataş, Semih Eren, Şeyda Dereli, Gündüz Durmuş
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引用次数: 0

Abstract

Background: Renin-angiotensin system (RAS) blockers constitute a cornerstone in the management of patients with cardiovascular disease. However, the relationship between the administration time of these drugs during the day and cardiovascular events is not yet fully elucidated. We aimed to examine the relationship between the administration time of RAS blockers during the day and long-term cardiovascular outcomes in patients with ST-segment elevation myocardial infarction (STEMI).

Methods: A total of 701 patients who were admitted to our hospital between 2018 and 2020 with STEMI and underwent primary percutaneous coronary intervention (PCI) were included in this single-center, retrospective, observational study. Primary endpoints were acute heart failure (AHF), nonfatal myocardial infarction, major adverse cardiovascular events (MACE), and long-term mortality. Patients were divided into two group according to the administration of RAS blockers in the morning (06:00-10:00) or evening (20:00-00:00).

Results: The mean age of the patients was 57.5 ± 11.9 years and 75.9% were male. After discharge, 485 patients were taking RAS blockers in the morning and 216 patients were taking them in the evening. There was a significantly higher rate of AHF, nonfatal myocardial infarction, MACE, and death in the group taking RAS blockers in the morning compared to the group taking them in the evening (p < 0.01, p = 0.02, p < 0.01, p < 0.01, respectively).

Conclusion: Routine administration of RAS blockers in the evening rather than in the morning led to a remarkable decrease in the occurrence of AHF, nonfatal myocardial infarction, MACE, and mortality.

STEMI患者RAS受体阻滞剂给药时机与长期心血管预后
背景:肾素-血管紧张素系统(RAS)阻滞剂是心血管疾病患者治疗的基石。然而,这些药物在白天的给药时间与心血管事件之间的关系尚未完全阐明。我们的目的是研究st段抬高型心肌梗死(STEMI)患者白天RAS受体阻滞剂给药时间与长期心血管预后之间的关系。方法:本研究为单中心、回顾性、观察性研究,纳入2018年至2020年期间我院收治的701例STEMI患者,并接受了原发性经皮冠状动脉介入治疗(PCI)。主要终点是急性心力衰竭(AHF)、非致死性心肌梗死、主要不良心血管事件(MACE)和长期死亡率。根据早上(06:00-10:00)或晚上(20:00-00:00)给药RAS受体阻滞剂将患者分为两组。结果:患者平均年龄57.5岁 ±11.9岁,男性占75.9%。出院后,485例患者上午服用RAS受体阻滞剂,216例患者晚上服用RAS受体阻滞剂。上午服用RAS受体阻滞剂组AHF、非致死性心肌梗死、MACE、死亡率明显高于晚上服用RAS受体阻滞剂组(p )。结论:晚间常规使用RAS受体阻滞剂可显著降低AHF、非致死性心肌梗死、MACE、死亡率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Herz
Herz 医学-心血管系统
CiteScore
3.00
自引率
5.90%
发文量
61
审稿时长
4-8 weeks
期刊介绍: Herz is the high-level journal for further education for all physicians interested in cardiology. The individual issues of the journal each deal with specific topics and comprise review articles in English and German written by competent and esteemed authors. They provide up-to-date and comprehensive information concerning the speciality dealt with in the issue. Due to the fact that all relevant aspects of the pertinent topic of an issue are considered, an overview of the current status and progress in cardiology is presented. Reviews and original articles round off the spectrum of information provided.
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