Relation between previous angiotensin-converting enzyme inhibitor use and in-hospital outcomes in acute coronary syndromes

Sheldon M Singh, Shaun G Goodman, Raymond T Yan, Jean-Pierre Dery, Graham C Wong, Richard Gallo, Francois R Grondin, Kevin Lai, Jose Lopez-Sendon, Keith A A Fox, Andrew T Yan, Canadian GRACE, GRACE(2) and CANRACE Investigators

Research output: Contribution to journalArticlepeer-review

Abstract

Angiotensin-converting enzyme (ACE) inhibitor use in patients at high risk of coronary artery disease has been associated with a decrease in the risk of myocardial infarction (MI) and death. However, it is unclear whether chronic use of these agents modifies the course and outcome of an acute coronary syndrome (ACS). This study assessed the association between chronic use of ACE inhibitors and clinical outcomes in patients with ACS. From 1999 through 2008, 13,632 Canadian patients with ACS were identified in the Global Registry of Acute Coronary Events (GRACE), the expanded GRACE (GRACE(2)), and the Canadian Registry of Acute Coronary Events (CANRACE). Patients were stratified by previous use of an ACE inhibitor. Clinical characteristics, in-hospital treatment, and outcomes were compared between the 2 groups. Multivariable logistic regression analysis adjusting for GRACE risk score and other clinical factors was performed. Patients receiving an ACE inhibitor before the ACS had a higher prevalence of diabetes (40.6% vs 21.2%, p
Original languageEnglish
Pages (from-to)332-6
Number of pages5
JournalAmerican Journal of Cardiology
Volume109
Issue number3
DOIs
Publication statusPublished - 2012

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