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Impact of renin-angiotensin system blockade therapy on outcome in aortic stenosis

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Impact of renin-angiotensin system blockade therapy on outcome in aortic stenosis. / Nadir, M. Adnan; Wei, Li; Elder, Douglas H. J.; Libianto, Renata; Lim, Tiong K.; Pauriah, Maheshwar; Pringle, Stuart D.; Doney, Alex D.; Choy, Anna-Maria; Struthers, Allan D.; Lang, Chim C. (Lead / Corresponding author).

In: Journal of the American College of Cardiology, Vol. 58, No. 6, 02.08.2011, p. 570-576.

Research output: Contribution to journalArticle

Harvard

Nadir, MA, Wei, L, Elder, DHJ, Libianto, R, Lim, TK, Pauriah, M, Pringle, SD, Doney, AD, Choy, A-M, Struthers, AD & Lang, CC 2011, 'Impact of renin-angiotensin system blockade therapy on outcome in aortic stenosis' Journal of the American College of Cardiology, vol 58, no. 6, pp. 570-576., 10.1016/j.jacc.2011.01.063

APA

Nadir, M. A., Wei, L., Elder, D. H. J., Libianto, R., Lim, T. K., Pauriah, M., ... Lang, C. C. (2011). Impact of renin-angiotensin system blockade therapy on outcome in aortic stenosis. Journal of the American College of Cardiology, 58(6), 570-576. 10.1016/j.jacc.2011.01.063

Vancouver

Nadir MA, Wei L, Elder DHJ, Libianto R, Lim TK, Pauriah M et al. Impact of renin-angiotensin system blockade therapy on outcome in aortic stenosis. Journal of the American College of Cardiology. 2011 Aug 2;58(6):570-576. Available from: 10.1016/j.jacc.2011.01.063

Author

Nadir, M. Adnan; Wei, Li; Elder, Douglas H. J.; Libianto, Renata; Lim, Tiong K.; Pauriah, Maheshwar; Pringle, Stuart D.; Doney, Alex D.; Choy, Anna-Maria; Struthers, Allan D.; Lang, Chim C. (Lead / Corresponding author) / Impact of renin-angiotensin system blockade therapy on outcome in aortic stenosis.

In: Journal of the American College of Cardiology, Vol. 58, No. 6, 02.08.2011, p. 570-576.

Research output: Contribution to journalArticle

Bibtex - Download

@article{1ef09ed652b44974b2882f625e0de9d3,
title = "Impact of renin-angiotensin system blockade therapy on outcome in aortic stenosis",
keywords = "Angiotensin-converting enzyme inhibitors, Angiotensin receptor blockers, Aortic stenosis, Converting enzyme inhibitors, Pressure overload hypertrophy, Left ventricular hypertrophy, Normal coronary arteries, Valve disease, Heart failure, Diastolic disfunction, Delay progression, Replacement, Angina",
author = "Nadir, {M. Adnan} and Li Wei and Elder, {Douglas H. J.} and Renata Libianto and Lim, {Tiong K.} and Maheshwar Pauriah and Pringle, {Stuart D.} and Doney, {Alex D.} and Anna-Maria Choy and Struthers, {Allan D.} and Lang, {Chim C.}",
year = "2011",
doi = "10.1016/j.jacc.2011.01.063",
volume = "58",
number = "6",
pages = "570--576",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",

}

RIS (suitable for import to EndNote) - Download

TY - JOUR

T1 - Impact of renin-angiotensin system blockade therapy on outcome in aortic stenosis

A1 - Nadir,M. Adnan

A1 - Wei,Li

A1 - Elder,Douglas H. J.

A1 - Libianto,Renata

A1 - Lim,Tiong K.

A1 - Pauriah,Maheshwar

A1 - Pringle,Stuart D.

A1 - Doney,Alex D.

A1 - Choy,Anna-Maria

A1 - Struthers,Allan D.

A1 - Lang,Chim C.

AU - Nadir,M. Adnan

AU - Wei,Li

AU - Elder,Douglas H. J.

AU - Libianto,Renata

AU - Lim,Tiong K.

AU - Pauriah,Maheshwar

AU - Pringle,Stuart D.

AU - Doney,Alex D.

AU - Choy,Anna-Maria

AU - Struthers,Allan D.

AU - Lang,Chim C.

PY - 2011/8/2

Y1 - 2011/8/2

N2 - <p>Objectives The purpose of this study was to investigate the impact of renin-angiotensin system blockade therapy on outcomes in aortic stenosis (AS).</p><p>Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are perceived to be relatively contraindicated in AS. However, inhibitors of the renin-angiotensin system may be beneficial in AS through their cardioprotective and beneficial effects on left ventricular remodeling.</p><p>Methods The Health Informatics dispensed prescribing, morbidity, and mortality database for the population of Tayside, Scotland, was linked through a unique patient identifier to the Tayside echocardiography database (&gt; 110,000 scans). Patients with a diagnosis of AS from 1993 to 2008 were identified. Cox regression model (adjusted for confounding variables) and propensity score analysis were used to assess the impact of ACEIs or ARBs on all-cause mortality and cardiovascular (CV) events (CV death or hospitalizations).</p><p>Results A total of 2,117 patients with AS (mean age 73 +/- 12 years, 46% men) were identified and 699 (33%) were on ACEI or ARB therapy. Over a mean follow-up of 4.2 years, there were 1,087 (51%) all-cause deaths and 1,018 (48%) CV events. Those treated with ACEIs or ARBs had a significantly lower all-cause mortality with an adjusted hazard ratio of 0.76 (95% confidence interval: 0.62 to 0.92, p &lt; 0.0001) and fewer CV events with an adjusted hazard ratio of 0.77 (95% confidence interval: 0.65 to 0.92, p &lt; 0.0001). The outcome benefits of ACEIs/ARBs were further supported by propensity score analysis.</p><p>Conclusions This large observational study suggests that ACEI/ARB therapy is associated with an improved survival and a lower risk of CV events in patients with AS. (J Am Coll Cardiol 2011;58:570-6) (C) 2011 by the American College of Cardiology Foundation</p>

AB - <p>Objectives The purpose of this study was to investigate the impact of renin-angiotensin system blockade therapy on outcomes in aortic stenosis (AS).</p><p>Background Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are perceived to be relatively contraindicated in AS. However, inhibitors of the renin-angiotensin system may be beneficial in AS through their cardioprotective and beneficial effects on left ventricular remodeling.</p><p>Methods The Health Informatics dispensed prescribing, morbidity, and mortality database for the population of Tayside, Scotland, was linked through a unique patient identifier to the Tayside echocardiography database (&gt; 110,000 scans). Patients with a diagnosis of AS from 1993 to 2008 were identified. Cox regression model (adjusted for confounding variables) and propensity score analysis were used to assess the impact of ACEIs or ARBs on all-cause mortality and cardiovascular (CV) events (CV death or hospitalizations).</p><p>Results A total of 2,117 patients with AS (mean age 73 +/- 12 years, 46% men) were identified and 699 (33%) were on ACEI or ARB therapy. Over a mean follow-up of 4.2 years, there were 1,087 (51%) all-cause deaths and 1,018 (48%) CV events. Those treated with ACEIs or ARBs had a significantly lower all-cause mortality with an adjusted hazard ratio of 0.76 (95% confidence interval: 0.62 to 0.92, p &lt; 0.0001) and fewer CV events with an adjusted hazard ratio of 0.77 (95% confidence interval: 0.65 to 0.92, p &lt; 0.0001). The outcome benefits of ACEIs/ARBs were further supported by propensity score analysis.</p><p>Conclusions This large observational study suggests that ACEI/ARB therapy is associated with an improved survival and a lower risk of CV events in patients with AS. (J Am Coll Cardiol 2011;58:570-6) (C) 2011 by the American College of Cardiology Foundation</p>

KW - Angiotensin-converting enzyme inhibitors

KW - Angiotensin receptor blockers

KW - Aortic stenosis

KW - Converting enzyme inhibitors

KW - Pressure overload hypertrophy

KW - Left ventricular hypertrophy

KW - Normal coronary arteries

KW - Valve disease

KW - Heart failure

KW - Diastolic disfunction

KW - Delay progression

KW - Replacement

KW - Angina

UR - http://www.scopus.com/inward/record.url?scp=79960924614&partnerID=8YFLogxK

U2 - 10.1016/j.jacc.2011.01.063

DO - 10.1016/j.jacc.2011.01.063

M1 - Article

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 6

VL - 58

SP - 570

EP - 576

ER -

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