The beneficial effects of renin–angiotensin system blockades on 2 year outcomes in coronary artery ectasia patients

Abstract

Objectives: This study was designed to investigate the impact of renin–angiotensin system blockade (RASB) therapy with angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers on the outcomes of coronary artery ectasia (CAE).

Methods: The CAE patients identified by coronary angiography from our center were consecutively enrolled. We obtained the baseline discharge prescription of RASB from the medical records system and conducted follow-up through telephone interviews. Cox regression models, propensity score and subgroup analysis were used to assess the impact of RASB on all-cause mortality and non-fatal myocardial infarction. Both the unadjusted and adjusted Kaplan–Meier curves stratified by RASB therapy were plotted.

Results: There were 595 patients with CAE in total and 333 (56.0%) were prescribed RASB therapy. Over a 2 year follow-up time, 16 all-cause deaths and 10 non-fatal myocardial infarctions were identified. Those patients treated with RASB had a significantly lower all-cause mortality and non-fatal myocardial infarction rate with an adjusted hazard ratio of 0.32 (95% confidence interval: 0.13 to 0.77, p = .011). The outcome benefits of RASB therapy were further confirmed in the propensity score analysis and subgroup analysis.

Conclusions: This observational study suggests that RASB therapy is associated with a lower risk of all-cause mortality and non-fatal myocardial infarction in patients with CAE.

Keywords:

• Coronary artery ectasia
• renin angiotensin system
• angiotensin-converting enzyme inhibitors
• angiotensin receptor antagonists
• treatment outcomes

Transparency

Declaration of funding

This study was funded by a grant from the Beijing Municipal Science and Technology Commission (Grant No. Z151100004015045).

Author contributions: Y.T.W. and W.H.S. were involved in the study design, interpretation of results, and review and revision of drafts of the manuscript. Y.W. was involved in the statistical analysis of study. D.Y., K.F.D. and Y.J.W. helped with data collection.

Declaration of financial/other relationships

Y.T.W., Y.W., D.Y., K.F.D., Y.J.W. and W.H.S. have disclosed that they have no significant relationships with or financial interests in any commercial companies related to this study or article.

CMRO peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Acknowledgements

The authors thank Yanyan Zhao and Yinxiao Bai for their help in the design and statistical analysis of this work.