ACE Inhibitors/Beta Blockers Underutilized for Heart Attack Patients

Updated:Aug 24,2016
American Heart Association/American Stroke Association
Latest Get With The Guidelines® Quality Research
ACE Inhibitors/Beta Blockers Underutilized for Heart Attack Patients
Use of Renin-Angiotensin System Blockers in Acute Coronary Syndromes: Findings From Get With the Guidelines-Coronary Artery Disease Program. Bainey K, Armstrong P, Fonarow G, Cannon C, Hernandez A, Peterson E, Peacock WF, Laskey W, Zhao X, Schwamm L, Bhatt D.. [Epub 2/25/14] CIRCOUTCOMES.113.000422, doi: 10.1161/?CIRCOUTCOMES.113.000422

What is known:
  • Angiotensin converting enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) are known to improve survival following an acute coronary syndrome (ACS) and are American College of Cardiology/American Heart Association (ACC/AHA) guideline recommended.
  • However, contemporary use of ACEI/ARB therapy following an ACS at discharge is less clear.

What this study adds:
  • In a large cohort of patients admitted with an ACS and discharged home from a Get with the Guidelines–Coronary Artery Disease Program participating hospital, roughly one in five eligible patients failed to receive ACC/AHA Class I guideline recommended ACEI/ARB therapy (81.7%).
  • After adjustment, in-hospital coronary artery bypass grafting (CABG) and renal insufficiency were independently associated with lower use of ACEI/ARB therapy.
  • Additional quality improvement efforts focused on use of ACEI/ARB therapy are warranted.
Study Author:
Kevin Bainey is currently an Assistant Professor and Academic Interventional Cardiologist at the Mazankowski Alberta Heart Institute, University of Alberta. He maintains an Associate Faculty position at the Canadian VIGOUR Centre, University of Alberta. He is also the Director of the Interventional Cardiology Fellowship Program at the Mazankowski Alberta Heart Institute. 
Past education includes an undergraduate degree in Microbiology at the University of Alberta in 1998, Doctor of Medicine from University of Alberta in 2002, Internal Medicine and Cardiology training at the University of Alberta and Fellowship of the Royal College of Physicians and Surgeons of Canada in 2006 (Internal Medicine) and 2008 (Cardiology). He also completed an Interventional Cardiology Fellowship at Harvard University’s Brigham and Women’s Hospital in 2009. He was a Clinical Scholar in Interventional Cardiology at McMaster University from 2009-2011. He completed his Master of Science in Health Research Methodology from McMaster University in 2013.
He is the recipient of the Canadian Society for Clinical Investigation Resident Research Award (Alberta) and was a Clinical Research Student Presentation Award Nominee for the Canadian Cardiovascular Congress. He has received the University Of Alberta Department Of Medicine Research Award on numerous occasions throughout his training at the University of Alberta.

Bainey’s research efforts are widely published amongst academic and peer-evaluated journals. Currently, his research interests include reperfusion in STEMI. His work on spontaneous reperfusion has led to a definitive understanding of enhanced clinical outcomes seen in these patients. Additionally, Dr. Bainey has a special interest in ethnic-based clinical research focusing primarily on South Asians with established coronary artery disease.

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