Effect of statins and ACE inhibitors alone and in combination on clinical outcome in patients with coronary heart disease

Απλή σελίδα τεκμηρίου
dc.contributor.authorAthyros, V. G.en
dc.contributor.authorMikhailidis, D. P.en
dc.contributor.authorPapageorgiou, A. A.en
dc.contributor.authorBouloukos, V. I.en
dc.contributor.authorPehlivanidis, A. N.en
dc.contributor.authorSymeonidis, A. N.en
dc.contributor.authorElisaf, M. S.en
dc.date.accessioned2015-11-24T19:22:28Z
dc.date.available2015-11-24T19:22:28Z
dc.identifier.issn0950-9240-
dc.identifier.urihttps://olympias.lib.uoi.gr/jspui/handle/123456789/22166
dc.rightsDefault Licence-
dc.subjectAgeden
dc.subjectAnalysis of Varianceen
dc.subjectAngiotensin-Converting Enzyme Inhibitors/*pharmacologyen
dc.subjectCoronary Disease/epidemiology/*prevention & controlen
dc.subjectDrug Synergismen
dc.subjectDrug Therapy, Combinationen
dc.subjectFemaleen
dc.subjectGreece/epidemiologyen
dc.subjectHumansen
dc.subjectHyperlipidemias/*drug therapyen
dc.subjectHypolipidemic Agents/*pharmacologyen
dc.subjectLipids/blooden
dc.subjectMaleen
dc.subjectMiddle Ageden
dc.subjectTreatment Outcomeen
dc.titleEffect of statins and ACE inhibitors alone and in combination on clinical outcome in patients with coronary heart diseaseen
heal.abstractWe assessed the 'synergy' of statins and angiotensin-converting enzyme inhibitors (ACEI) in reducing vascular events in patients with coronary heart disease (CHD). The GREek Atorvastatin and CHD Evaluation (GREACE) Study, suggested that aggressive reduction of low density lipoprotein cholesterol to 2.59 mmol/l (<100 mg/dl) significantly reduces morbidity and mortality in CHD patients, in comparison to undertreated patients. In this post hoc analysis of GREACE the patients (n=1600) were divided into four groups according to long-term treatment: Group A (n=460 statin+ACEI), B (n=420; statin, no ACEI), C (n=371;no statin, on ACEI), and D (n=349; no statin, no ACEI). Analysis of variance was used to assess differences in the relative risk reduction (RRR) in 'all events' (primary end point) between groups. During the 3-year follow-up there were 292 cardiovascular events; 45 (10% of patients) in group A, 61 (14.5%) in group B, 91 in group C (24.5%) and 95 events in group D (27%). The RRR (95% confidence interval (CI) in the primary end point in group A was 31%, (95% CI -48 to -6%, P=0.01) in comparison to group B, 59% (95% CI -72 to -48%, P<0.0001) to group C and 63% (95% CI -74 to -51%, P<0.0001) to group D. There was no significant difference in RRR between groups C and D (9%, CI -27-10%, P=0.1). Other factors (eg the blood pressure) that can influence clinical outcome did not differ significantly between the four treatment groups. In conclusion, the statin+ACEI combination reduces cardiovascular events more than a statin alone and considerably more than an ACEI alone. Aggressive statin use in the absence of an ACEI also substantially reduced cardiovascular events. Treatment with an ACEI in the absence of a statin use reduced clinical events in comparison to patients not treated with an ACEI but not significantly, at least in these small groups of patients.en
heal.accesscampus-
heal.fullTextAvailabilityTRUE-
heal.identifier.primary10.1038/sj.jhh.1001748-
heal.identifier.secondaryhttp://www.ncbi.nlm.nih.gov/pubmed/15229622-
heal.identifier.secondaryhttp://www.nature.com/jhh/journal/v18/n11/pdf/1001748a.pdf-
heal.journalNameJ Hum Hypertensen
heal.journalTypepeer-reviewed-
heal.languageen-
heal.publicationDate2004-
heal.recordProviderΠανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικήςel
heal.typejournalArticle-
heal.type.elΆρθρο Περιοδικούel
heal.type.enJournal articleen

Αρχεία

Φάκελος/Πακέτο αδειών

Προβολή: 1 - 1 of 1
Μικρογραφία εικόνας
Ονομα:
license.txt
Μέγεθος:
1.74 KB
Μορφότυπο:
Item-specific license agreed upon to submission
Περιγραφή:
Κατεβάστε

Συλλογές

Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά) - ΙΑΤ