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KMID : 0191120230380250202
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Journal of Korean Medical Science
2023 Volume.38 No. 25 p.202 ~ p.202
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Comparison Between Fimasartan Versus Other Angiotensin Receptor Blockers in Patients With Heart Failure After Acute Myocardial Infarction
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Kim Ji-Hoon
Kang Dan-Bee
Baek Ji-Hyun
Park Hye-Jeong
Park Taek-Kyu
Lee Joo-Myung
Yang Jeong-Hoon
Song Young-Bin
Choi Jin-Ho
Choi Seung-Hyuk
Gwon Hyeon-Cheol
Eliseo Guallar
Cho Ju-Hee
Hahn Joo-Yong
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Abstract
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Backgrounds : Fimasartan is the most recently developed, potent, and long-acting angiotensin II receptor blocker (ARB). However, data are limited regarding treatment effects of fimasartan in patients with heart failure.
Methods : Between 2010 and 2016, patients who underwent coronary revascularization for myocardial infarction (MI) with heart failure and prescription of ARB at hospital discharge were enrolled from the Korean nationwide medical insurance data. Clinical outcomes were compared between patients receiving fimasartan and those receiving other ARBs (candesartan, valsartan, losartan, telmisartan, olmesartan, and irbesartan). The primary outcome was a composite of all-cause death, recurrent MI, hospitalization for heart failure, and stroke.
Results : Of 2,802 eligible patients, fimasartan was prescribed to 124 patients (4.4%). During a median follow-up of 2.2 years (interquartile range, 1.0?3.9), 613 events of the primary outcome occurred. There was no significant difference in the primary outcome between patients receiving fimasartan and those receiving other ARBs (adjusted hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.46?1.45). Compared with patients receiving other ARBs, those receiving fimasartan had comparable incidence of all-cause death (adjusted HR, 0.70; 95% CI, 0.30?1.63), recurrent MI (adjusted HR, 1.28; 95% CI, 0.49?3.34), hospitalization for heart failure (adjusted HR, 0.70; 95% CI, 0.27?1.84), and stroke (adjusted HR, 0.59; 95% CI, 0.18?1.96).
Conclusion : In this nationwide cohort, fimasartan, compared with other ARBs, had comparable treatment effects for a composite of all-cause death, recurrent MI, hospitalization for heart failure, and stroke in patients with heart failure after MI.
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KEYWORD
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Angiotensin Receptor Blocker, Myocardial Infarction, Heart Failure
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