Angiotensin Receptor Blockers Decrease the Risk of Major Adverse Cardiovascular Events in Patients with End-Stage Renal Disease on Maintenance Dialysis: A Nationwide Matched-Cohort Study
| Autor: | Chien Hsun Li, Nian-Sheng Tzeng, Chung-Wei Yang, Shih Hsiang Chiu, Hung An Chen, Shinn-Ying Ho, Yun Ju Yin, Hui Ling Huang |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent medicine.medical_treatment Taiwan Renal function lcsh:Medicine urologic and male genital diseases End stage renal disease Peritoneal dialysis Cohort Studies Angiotensin Receptor Antagonists Young Adult Diabetes mellitus Internal medicine medicine Humans cardiovascular diseases lcsh:Science Dialysis Antihypertensive Agents Aged Multidisciplinary business.industry lcsh:R Middle Aged medicine.disease female genital diseases and pregnancy complications Cardiovascular Diseases Hypertension Cardiology Kidney Failure Chronic Female lcsh:Q business Peritoneal Dialysis Mace Cohort study Research Article |
| Zdroj: | PLoS ONE, Vol 10, Iss 10, p e0140633 (2015) PLoS ONE |
| ISSN: | 1932-6203 |
| Popis: | Background Major adverse cardiovascular events (MACE) cause the leading cause of morbidity and mortality in patients with end-stage renal disease (ESRD) on maintenance Hemodialysis (HD) or peritoneal dialysis (PD). Many randomized-controlled trials (RCTs) have proved that angiotensin receptor blockers (ARBs) can reduce the risk of MACE in the people with normal or impaired kidney function without dialysis. This study seeks to clarify whether ARBs therapy could also attenuate this risk in patients with ESRD on maintenance dialysis. Materials and Methods The National Health Research Institute provided a database of one million random subjects for the study. A random sample was taken of 1800 patients ≥18 years y/o with ESRD on dialysis without a history of MACE and use of ARBs within 6-months prior to enrollment. Cox proportional hazard regression analysis was used to identify the risk factors and compute the hazard ratios accompanying 95% confidence intervals. Results In these 1800 patients, 1061 had never used ARBs, while 224 had used them for 1–90 days, and 515 had used them for more than 90 days. We found that ARBs significantly decrease the incidences of acute myocardial infarctions (AMI), coronary artery diseases (CAD) requiring coronary stent or percutaneous transluminal coronary angioplasty (PTCA), peripheral artery disease (PAD) requiring percutaneous transluminal angioplasty (PTA), and acute stroke. Cumulative prescription days of ARBs beyond 365–760 days or more were found to be negatively correlated with incidence of MACEs. For patients with dual comorbidity (i.e., mellitus and hyperlipidemia), 91–365 cumulative prescription days might also attenuate the risk. Conclusions For patients on maintenance dialysis, the use of ARBs could significantly attenuate the risk of major cardiovascular events: AMI, acute stroke, and PAD requiring PTA. |
| Databáze: | OpenAIRE |
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