J Korean Med Sci.  2023 Jun;38(25):e202. 10.3346/jkms.2023.38.e202.

Comparison Between Fimasartan Versus Other Angiotensin Receptor Blockers in Patients With Heart Failure After Acute Myocardial Infarction

• Kim J
• Kang D
• Kim SE
• Park H
• Park TK
• Lee JM
• Yang JH
• Song YB
• Choi JH
• Choi SH
• Gwon HC
• Guallar E
• Cho J
• Hahn JY

• KMID: 2544012
• DOI: http://doi.org/10.3346/jkms.2023.38.e202

Abstract

Background
s: 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.

Keyword

Angiotensin Receptor Blocker; Myocardial Infarction; Heart Failure

Figure

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  Fig. 1 Flow chart of subjected patients.ACEI = angiotensin-converting enzyme inhibitor, ARB = angiotensin II receptor blocker, CABG = coronary artery bypass grafting, MI = myocardial infarction, PCI = percutaneous coronary intervention.

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  Fig. 2 Clinical outcomes according to different types of angiotensin II receptor blockers.aA composite of all-cause death, recurrent myocardial infarction, hospitalization for heart failure, and stroke.

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