The differential effect of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers with respect to foot ulcer and limb amputation in those with diabetes

Autor:	Warren B. Bilker, Robert M. Cohen, Ole Hoffstad, Arturo R. Maldonado, Timothy M. Crombleholme, David J. Margolis, Bruce J. Aronow, Stephen R. Thom
Rok vydání:	2010
Předmět:	medicine.medical_specialty Angiotensin Receptor Antagonists biology business.industry medicine.medical_treatment Hazard ratio Angiotensin-converting enzyme Retrospective cohort study Dermatology medicine.disease Diabetic foot Surgery Amputation Internal medicine Diabetes mellitus medicine biology.protein cardiovascular diseases business Kidney disease
Zdroj:	Wound Repair and Regeneration. 18:445-451
ISSN:	1067-1927
DOI:	10.1111/j.1524-475x.2010.00624.x
Popis:	Diabetic foot ulcers (DFU) or lower extremity amputation (LEA) are complications of diabetes. In those with diabetes, angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are commonly used to prevent the progression of kidney disease. Recent studies have indicated that angiotensin may affect angiogenesis and wound repair. Our goal was to evaluate in those with diabetes the likelihood of developing a DFU or LEA among users of ACEi or ARB using a retrospective cohort design of general practices in the United Kingdom. We studied 40,342 individuals at least 35 years of age with diabetes who were first prescribed ACEi or ARB between 1995 and 2006. A total of 35,153 individuals were treated with ACEi, 12,437 individuals with ARB, and 7,310 both. The hazard ratio for DFU was 0.50 (95% confidence intervals: 0.43, 0.59), showing an increased risk of DFU for those using ACEi vs. ARB. The hazard ratio for LEA was 0.72 (0.48, 1.01). However, among those with lower extremity peripheral arterial disease the hazard ratio was 0.45 (0.22, 0.91) for the new onset of a LEA. In conclusion, among those with diabetes, exposure to ACEi as compared with ARB increases the risk of developing a DFU or LEA.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::4301032651cbfddd540bd7f9441c4789 https://doi.org/10.1111/j.1524-475x.2010.00624.x Zobrazit plný text záznamu Plný text ve formátu PDF Plný text ve formátu HTML
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