Treatment effects of renin-angiotensin system inhibitor and calcium channel blocker in patients with coronary artery narrowing (from the Japanese Coronary Artery Disease Study)
Autor: | Takahide Kohro, Ryozo Nagai, Masatoshi Fujita, Tsutomu Yamazaki, Shigetake Sasayama, Doubun Hayashi, Fumio Terasaki, Satoko Mitani, Yoshihiro Okada, Tatsuya Morimoto |
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Rok vydání: | 2010 |
Předmět: |
Male
Relative risk reduction medicine.medical_specialty Time Factors Combination therapy medicine.drug_class Angiotensin-Converting Enzyme Inhibitors Blood Pressure Kaplan-Meier Estimate Calcium channel blocker Coronary Angiography Risk Assessment Coronary artery disease Renin-Angiotensin System Japan Risk Factors Internal medicine medicine Clinical endpoint Humans Antihypertensive Agents Aged Chi-Square Distribution business.industry Coronary Stenosis Middle Aged Calcium Channel Blockers medicine.disease Renin-angiotensin system inhibitor Coronary arteries Treatment Outcome medicine.anatomical_structure Blood pressure Cardiovascular Diseases Cardiology Drug Therapy Combination Female Cardiology and Cardiovascular Medicine business Angiotensin II Type 1 Receptor Blockers Artery |
Zdroj: | Heart and Vessels. 25:453-459 |
ISSN: | 1615-2573 0910-8327 |
DOI: | 10.1007/s00380-010-0012-5 |
Popis: | Low-dose antihypertensive drugs in combination are prescribed frequently in clinical practice. Combination treatment is superior to monotherapy with higher doses of each drug in terms of blood pressure reduction and side effects. However, it is unclear whether combination treatment provides additional prognostic benefit beyond the blood pressure lowering effects. We assessed the usefulness of the combined treatment of a renin-angiotensin system inhibitor (RASI) and a calcium channel blocker (CCB) for all cardiovascular events in the Japanese Coronary Artery Disease (JCAD) Study population. In the JCAD Study, which is an observational and non-randomized trial, 13,812 patients with angiographically shown narrowing >50% in ≥1 of 3 major coronary arteries were followed up for a mean of 2.7 years. The primary endpoint of the study was all cardiovascular events. In the present study, baseline covariates possibly influencing the event rate were adjusted between the different treatment groups. There was no statistically significant difference in the event rate between the RASI monotherapy and combined treatment groups, although Kaplan-Meier analysis showed a 23% (p = 0.0003) relative risk reduction with an RASI monotherapy compared with the control group. In conclusion, there may be no additional benefit beyond blood pressure lowering effects in the combination of an RASI and a CCB in patients with angiographically documented CAD. |
Databáze: | OpenAIRE |
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