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Use of angiotensin-converting enzyme inhibitors and cardiovascular outcomes following primary vascular surgery: a nationwide propensity score matched follow-up study.
- Source :
-
Vascular and endovascular surgery [Vasc Endovascular Surg] 2012 Oct; Vol. 46 (7), pp. 515-23. Date of Electronic Publication: 2012 Jul 27. - Publication Year :
- 2012
-
Abstract
- Objective: To examine the association between angiotensin-converting enzyme (ACE) inhibitor use and clinical outcome after primary vascular reconstruction in a population-based follow-up study.<br />Methods: All Danish patients undergoing primary vascular surgical reconstruction between 1996 and 2007 were included. For each ACE user up to 5 nonuser was identified using propensity score matching followed by Cox regression. All drugs were included as time-dependent variables.<br />Results: Totally 17 495 matched patients with a median follow-up period of 582 days were included. All-cause mortality was 20.4% for ACE users and 24.9% for nonusers (adjusted hazard ratio [adj HR] 0.88, 95% confidence interval [CI] 0.81-0.96). The cumulative risk of myocardial infarction was 6.2% for ACE users and 4.7% for nonusers (adj HR 1.20, 95%CI 1.03-1.39). Cumulative risk of new vascular surgery was 24.0% for ACE users and 23.1% for nonusers (adj HR 1.21, 95% CI 1.13-1.30). No differences were seen concerning stroke and major amputation.<br />Conclusion: The ACE use was associated with lower all-cause mortality but also an increased long-term risk of recurrent vascular reconstruction.
- Subjects :
- Adult
Aged
Aged, 80 and over
Cardiovascular Diseases diagnosis
Cardiovascular Diseases etiology
Cardiovascular Diseases mortality
Cardiovascular Diseases surgery
Denmark
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction etiology
Peripheral Arterial Disease mortality
Propensity Score
Proportional Hazards Models
Registries
Reoperation
Risk Factors
Time Factors
Treatment Outcome
Vascular Surgical Procedures mortality
Angiotensin-Converting Enzyme Inhibitors therapeutic use
Cardiovascular Diseases drug therapy
Peripheral Arterial Disease surgery
Vascular Surgical Procedures adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1938-9116
- Volume :
- 46
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Vascular and endovascular surgery
- Publication Type :
- Academic Journal
- Accession number :
- 22843293
- Full Text :
- https://doi.org/10.1177/1538574412455229