RAS Inhibitor Benefits After Stent for Myocardial Infarction Are Concentrated in the First Year

Korea University Guro Hospital and Honam University team analyze KAMIR-NIH data
Confirm 55% reduction in mortality within 12 months

A Korean study has found that, in patients with acute myocardial infarction who undergo stent implantation, the survival benefit of renin-angiotensin system (RAS) inhibitors is concentrated within the first year after initiation. Long-term continuation of the medication beyond that period did not show a clear association with additional survival gains.

Korea University Guro Hospital

Korea University Guro Hospital announced on the 20th that a joint research team led by Professor Na Seungwoon of the Cardiovascular Center and Professor Choi Byunggeol of the Department of Clinical Laboratory Science at Honam University analyzed 5,017 Korean patients with ST-segment elevation myocardial infarction (STEMI) who received drug-eluting stents using data from the Korea Acute Myocardial Infarction Registry–National Institutes of Health (KAMIR-NIH), and confirmed these findings.

The analysis showed that patients who took RAS inhibitors within 12 months after discharge had a 55% lower risk of all-cause mortality compared with those who did not. During this period, improvements in left ventricular ejection fraction and blood pressure control were also statistically significantly greater.

In contrast, among patients who survived the first year after the procedure without major cardiovascular events, there was no significant correlation between continued use of RAS inhibitors from 12 to 36 months and survival.

The research team emphasized the significance of supplementing the previous clinical gap regarding the need for long-term use beyond the acute phase with real-world clinical data. Professor Na explained that the first year after the procedure is the critical period during which the survival benefit is concentrated, and that, thereafter, individualized strategies for maintaining medication are needed, taking into account the degree of cardiac function recovery and other factors.

The study is being evaluated as providing objective evidence to guide clinical decisions about whether to maintain long-term therapy. The researchers said, "By clearly demonstrating the importance of treatment in the first year for myocardial infarction patients, who often face a heavy burden of polypharmacy, this study may also help improve treatment adherence." The results were published on the 6th in the international journal Coronary Artery Disease.

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