BackgroundCurrent guidelines recommend angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin-receptor blockers (ARB) or -blockers (-B) for secondary prevention in patients after an acute myocardial infarction (AMI). However, there is limited data to evaluate ACEI/ARB/-B (AA) used before AMI on major adverse cardiovascular events (MACE), in China patients.ObjectivesThis study sought to investigate whether AA treatment prior to AMI is associated with better hospital outcomes at the onset of AMI.MethodsA total of 2705 patients were selected from the Cardiovascular Center Beijing Friendship Hospital Database Bank, and divided into two groups on the basis of admission prescription: AA (n=872) or no-AA (n=1833). The study was also designed using propensity-score matching (226 AA treated patients vs 452 no-AA treated patients). The primary outcome was a composite of cardiac death and heart function and infarct size during hospitalization follow-up.ResultsThe mean follow-up period was about 8days in MACE. The Cox model showed the two groups had similar risk of cardiac death. The in-hospital mortality was 3.36% (3.33% of AA users and 3.38% of nonusers, p=0.94). In adjusted analysis, there was still no difference in in-hospital mortality between the two groups (3.54% vs 2.88%, p=0.64). However, the AA treated patients were associated with better heart function and smaller infarct size than the no-AA treated patients.ConclusionsThe in-hospital MACE was similar between AA treated patients and no-AA treated patients. However, treatment with AA before AMI was associated with improved heart function and smaller infarct size.