Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Ischemic Heart Disease
Plasma Renin Activity Is an Independent Prognosticator in Patients With Myocardial Infarction
Daisuke KamonHiroyuki OkuraAkihiko OkamuraYasuki NakadaYukihiro HashimotoYu SugawaraTomoya UedaTaku NishidaKenji OnoueTsunenari SoedaSatoshi OkayamaMakoto WatanabeRika KawakamiYoshihiko Saito
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2019 年 83 巻 6 号 p. 1324-1329

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Background:Plasma renin activity (PRA) is associated with cardiovascular events in patients with heart failure (HF), but its prognostic role in acute myocardial infarction (AMI) is unclear.

Methods and Results:A total of 878 patients with information on baseline PRA on admission were selected from 1,055 AMI patients who underwent emergency coronary angiography between 2007 and 2016. The patients were divided into 2 groups according to their median PRA (2.0 ng/mL/h). The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiovascular death and hospitalization because of HF. During follow-up (median 4.5±3.1 years), MACE occurred in 108 patients. Kaplan-Meier analysis showed that the high PRA group had significantly lower MACE-free survival than the low PRA group (log-rank P=0.0009). By multivariate analysis, high PRA was an independent predictor of MACE (hazard ratio (HR) 1.573; 95% confidence interval (CI) 1.049–2.396, P=0.0282). Similarly, among 580 patients who had not been previously treated with renin-angiotensin system inhibitors or β-blockers on admission, high PRA was an independent predictor of MACE (HR 1.732; 95% CI 1.010–3.047, P=0.0460).

Conclusions:In the studied AMI patients, elevated levels of PRA were independently associated with poor prognosis.

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© 2019 THE JAPANESE CIRCULATION SOCIETY
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