Abstract 15470: The Impact of Angiotensin Converting Enzyme Inhibitor versus Angiotensin Receptor Blocker on Clinical Outcomes in Patients Undergoing Endovascular Intervention for Peripheral Artery Disease
Backgrounds: Angiotensin-converting enzyme inhibitors (ACEI) have a well-established role in the treatment of patients (pts) with high risks of cardiovascular disease. The aim of this study is to evaluate the impact of ACEI versus angiotensin receptor blocker (ARB) of the on clinical outcomes in pts with peripheral artery disease (PAD) who underwent percutaneous transluminal angioplasty (PTA).
Methods: The outcomes of 518 consecutive pts with symptomatic PAD who underwent PTA from November 2004 to October 2012 at Korea University Guro Hospital were enrolled for analysis. Pts were divided into the three groups; PAD without ACEI or ARB (n=253), PAD with ACEI (n=61), and PAD with ARB (n=204). One-year clinical outcomes were compared among the 3 groups.
Results: Left ventricular ejection fraction (LVEF) was lowest in PAD pts with ACEI (P=0.004) and the prevalence of hypertension (p<0.001) and diabetes mellitus (p=0.005) was highest in PAD pts with ARB, and the use of beta blocker was highest in PAD patients with ACEI (p<0.001). The incidence of claudication and resting pain as the initial diagnosis for PAD were similar among the 3 groups. At 1-year follow up, the incidence of repeat revascularization of coronary artery disease (CAD) was lowest in PAD pts with ACEI (p=0.025) and adjusted multiple regression showed that ACEI was an independent predictor for preventing repeated revascularization of CAD (Hazard ratio 0.345, confidence interval 0.776-1.87, p=0.009).
Conclusion: In this study, although there were more cardiovascular risks in PTA pts with ACEI, they had similar peripheral outcomes. Further, the use of ACEI was useful to prevent repeated revascularization of CAD.
Author Disclosures: J. Park: None. S. Rha: None. S. Ryu: None. J. Choi: None. B. Choi: None. J. Byun: None. S. Choi: None. J. Kang: None. W. Kim: None. J. Choi: None. E. Park: None. S. Park: None. S. Lee: None. H. Li: None. J. Na: None. C. Choi: None. J. Kim: None. H. Lim: None. E. Kim: None. C. Park: None. H. Seo: None. D. Oh: None.
- © 2016 by American Heart Association, Inc.