{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T19:22:15Z","timestamp":1787772135774,"version":"build-2784847793"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Despite guideline recommendations, suboptimal prescription rates of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) have been observed in patients with acute coronary syndrome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>This study aimed to examine the temporal trends, variations, and mortality outcomes among acute coronary syndrome patients prescribed ACEIs\/ARBs in the multi-ethnic population of Malaysia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology:<\/jats:title>\n                    <jats:p>\n                      This retrospective study utilized data from the Malaysian National Cardiovascular Disease\u2013Acute Coronary Syndrome registry, encompassing consecutive patient records from 2008 to 2017 (\n                      <jats:italic toggle=\"yes\">N<\/jats:italic>\n                      = 60,854). Ten-year temporal trends of on-discharge ACEIs\/ARBs prescription were examined. Demographics, clinical characteristics and 1-year all-cause mortality outcomes were compared between patients prescribed and not prescribed ACEIs\/ARBs.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      The 10-year prescription rate of on-discharge ACEIs\/ARBs was 52.8% (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 32,140), with a significant decline over the years [linear trend test,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.008; SD = 0.03; SE = 0.001; 95% CI = 0.55-0.64]. Patients aged \u226565 years (aOR = 0.79; 95% CI = 0.73\u20130.86) were less likely to be prescribed ACEIs\/ARBs than those aged &lt;65 years. In addition, patients with comorbid diabetes mellitus (DM) (aOR = 0.85; 95% CI = 0.79\u20130.92) and chronic kidney disease (CKD) (aOR = 0.34; 95% CI = 0.30\u20130.40) were significantly less likely to receive ACEIs\/ARBs. IPW-adjusted survival analysis revealed a 38% lower 1-year all-cause mortality rate in patients prescribed on-discharge ACEIs\/ARBs (HR = 0.62; 95% CI = 0.56\u20130.69;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Acute coronary syndrome patients with concomitant DM and CKD were less likely to receive on-discharge ACEIs\/ARBs in Malaysia. Suboptimal prescription rates of ACEIs\/ARBs persisted over the 10-year period, despite improved 1-year survival in ACS patients prescribed ACEIs\/ARBs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sjmms.sjmms_422_23","type":"journal-article","created":{"date-parts":[[2024,4,10]],"date-time":"2024-04-10T04:02:52Z","timestamp":1712721772000},"page":"145-152","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Prescribing Trends of Renin-Angiotensin System Inhibitors and Mortality among Acute Coronary Syndrome Patients: Insights from the Malaysian National Cardiovascular Disease Registry"],"prefix":"10.4103","volume":"12","author":[{"given":"Siti Zaleha","family":"Suki","sequence":"first","affiliation":[{"name":"Department of Pharmacology, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia"},{"name":"Department of Centre of Preclinical Science Studies, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmad Syadi Mahmood","family":"Zuhdi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology, Faculty of Medicine, University of Malaya, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abqariyah","family":"Yahya","sequence":"additional","affiliation":[{"name":"Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wan Ahmad Hafiz Wan Md","family":"Adnan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Nephrology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nur Lisa","family":"Zaharan","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Faculty of Dentistry, Universiti Teknologi MARA, Selangor, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,4,5]]},"reference":[{"key":"R1-20240909","doi-asserted-by":"crossref","first-page":"18","DOI":"10.3317\/jraas.2000.002","article-title":"The hope study (heart outcomes prevention evaluation)","volume":"1","author":"Sleight","year":"2000","journal-title":"J Renin Angiotensin Aldosterone Syst"},{"issue":"Suppl 3","key":"R2-20240909","doi-asserted-by":"crossref","first-page":"S82","DOI":"10.1002\/dmrr.285","article-title":"Reduction of cardiovascular events and microvascular complications in diabetes with ACE inhibitor treatment:Hope and micro-hope","volume":"18","author":"Gerstein","year":"2002","journal-title":"Diabetes Metab Res Rev"},{"key":"R3-20240909","doi-asserted-by":"crossref","first-page":"782","DOI":"10.1016\/S0140-6736(03)14286-9","article-title":"European Trial on Reduction of Cardiac Events with Perindopril in Stable Coronary Artery Disease Investigators. 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