• François-Xavier Lapébie, Alessandra Bura-Rivière, Philippe Lacroix, Joël Constans, Carine Boulon, Emmanuel Messas, Victor Aboyans, Jean Ferrières, and Vanina Bongard.
• Department of vascular medicine, Toulouse University Hospital, Toulouse, France.
• Eur Heart J Cardiovasc Pharmacother. 2020 Apr 9.

AimsThe objective was to assess the association between angiotensin-converting-enzyme inhibitors (ACEI) or angiotensin receptor blockers (ARB) prescription at discharge in patients hospitalized for symptomatic lower extremity artery disease (LEAD) and one-year mortality.Methods And ResultsThe COPART registry is a multicentre, prospective, observational, cohort study which includes consecutive patients hospitalized for symptomatic LEAD in 4 French academic centres. All-cause mortality during a one-year follow-up after hospital discharge was compared between patients with ARB, patients with ACEI and patients without ARB or ACEI. Analyses were performed using Cox models. As a sensitivity analysis, a propensity score (PS)-matching analysis was carried out. Among 1,981 patients, 421 had ARB (21.3%), 766 ACEI (38.7%), and 794 no ACEI/ARB (40.1%) at discharge. During the one-year follow-up, incidence rates for mortality were 12.6/100 person-years (95% confidence interval, 9.7-16.1) for patients with ARB, 15.8/100 person-years (95%CI, 13.4-18.6) for patients with ACEI and 19.8/100 person-years for patients without ACEI/ARB (95%CI, 17.2-22.8). In a multivariate Cox model, ARB at discharge was associated with decreased mortality compared with no ACEI/ARB, hazard ratio (HR) 0.68 (95%CI, 0.49-0.95), and with ACEI, HR 0.69 (95%CI, 0.49-0.97). These results are consistent with those obtained by the Cox analyses in the PS-matched sample: HR 0.68 (95%CI, 0.47-0.98) for patients with ARB compared with no ARB.ConclusionARB at discharge after hospitalization for symptomatic LEAD is associated with a better survival compared with ACEI or no ACEI/ARB.© Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2020. For permissions, please email: journals.permissions@oup.com.

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