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Oger E, Kerbrat S, Nowak E, Paillard F, Scarabin PY, Happe A. Effectiveness of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on total and cardiovascular mortality and morbidity in primary prevention: A nationwide study based on French Health Insurance Data (SNDS). J Clin Hypertens (Greenwich) 2022; 24:438-448. [PMID: 35229448 PMCID: PMC8989753 DOI: 10.1111/jch.14445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 11/29/2022]
Abstract
Angiotensin‐converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) both inhibit the renin‐angiotensin system (RAS) but have different sites of action. Whether clinically meaningful differences exist is still debated. The authors set up a population‐based nationwide retrospective cohort study with at least 5 years of follow‐up based on the comprehensive French Health Insurance Database linked to the French hospital discharge database. Patients aged 50 or above, identified as ARB or ACE inhibitor new users in 2009 (at least one delivery during the year and no such delivery in 2008) were eligible. Exclusion criteria included history of cancer, cardiovascular disease, or chronic renal insufficiency. Main outcome measure was overall mortality. Secondary outcomes were cardiovascular deaths, major cardiovascular events, and major or other cardiovascular events. Out of 407 815 eligible patients, 233 682 (57%) were ARB users; two‐third had no previous exposure to antihypertensive drug. Based on propensity‐score based Cox model, ARB new user group had a better overall (HR: .878, 95%CI, .854 to .902), and cardiovascular (HR: .841, 95%CI, .800 to .84) survival and had a lower risk for major cardiovascular events (HR: .886, 95%CI, .868 to .905). Statistically significant quantitative interactions were detected with diabetes. Considering subgroup analyses, ARBs had a better survival than ACE inhibitors in nondiabetic patients.
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Affiliation(s)
- Emmanuel Oger
- Univ Rennes, EA 7449 REPERES [Pharmacoepidemiology and Health Services Research], Rennes, France
| | - Sandrine Kerbrat
- Univ Rennes, EA 7449 REPERES [Pharmacoepidemiology and Health Services Research], Rennes, France
| | - Emmanuel Nowak
- Université de Bretagne Loire, Université de Brest, INSERM CIC 1412, CHRU de Brest, Brest, Bretagne, France
| | | | - Pierre-Yves Scarabin
- Center for Research in Epidemiology and Population Health, INSERM, Villejuif, France
| | - André Happe
- Univ Rennes, EA 7449 REPERES [Pharmacoepidemiology and Health Services Research], Rennes, France
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Kirakosyan A, Gutierrez E, Ramos Solano B, Seymour EM, Bolling SF. The inhibitory potential of Montmorency tart cherry on key enzymes relevant to type 2 diabetes and cardiovascular disease. Food Chem 2018; 252:142-146. [DOI: 10.1016/j.foodchem.2018.01.084] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 12/07/2017] [Accepted: 01/11/2018] [Indexed: 12/13/2022]
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Shariatinia Z, Zahraee Z. Controlled release of metformin from chitosan–based nanocomposite films containing mesoporous MCM-41 nanoparticles as novel drug delivery systems. J Colloid Interface Sci 2017; 501:60-76. [DOI: 10.1016/j.jcis.2017.04.036] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Revised: 04/11/2017] [Accepted: 04/11/2017] [Indexed: 10/19/2022]
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Zha D, Cheng H, Li W, Wu Y, Li X, Zhang L, Feng YH, Wu X. High glucose instigates tubulointerstitial injury by stimulating hetero-dimerization of adiponectin and angiotensin II receptors. Biochem Biophys Res Commun 2017; 493:840-846. [PMID: 28870804 DOI: 10.1016/j.bbrc.2017.08.047] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 08/13/2017] [Indexed: 01/04/2023]
Abstract
Abnormal expression and dysfunction of adiponectin and the cognate receptors are involved in diabetes and diabetic kidney disease (DKD), whereas angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEIs) alleviate diabetic albuminuria and prevent development of DKD through upregulation of adiponectin expression. Here we report that high glucose stimulates expression of angiotensin II (AngII) receptors (AT1 and AT2) in renal proximal tubular epithelial cells (NRK-52E). These receptors underwent hetero-dimerization with adiponectin receptor AdipoR1 and AdipoR2, respectively. High glucose inhibited the dimerization between AT1 and AT2. Interestingly, these hetero-dimers instigated tubulointerstitial injury by inhibiting the cytoprotective action of the adiponectin receptors. These modes of receptor-receptor hetero-dimerization may contribute to high glucose-induced renal tubulointerstitial injury and could be potential therapeutic targets.
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Affiliation(s)
- Dongqing Zha
- Division of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Huaiyan Cheng
- Dept. of Pharmacology & Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Weiwei Li
- Division of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yizhe Wu
- Division of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xiaoning Li
- Division of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Lian Zhang
- Division of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Ying-Hong Feng
- Dept. of Pharmacology & Molecular Therapeutics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Xiaoyan Wu
- Division of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, China.
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Choi SY, Choi BG, Rha SW, Byun JK, Shim MS, Li H, Mashaly A, Choi CU, Park CG, Seo HS, Oh DJ, Jeong MH. Angiotensin-converting enzyme inhibitors versus angiotensin II receptor blockers in acute ST-segment elevation myocardial infarction patients with diabetes mellitus undergoing percutaneous coronary intervention. Int J Cardiol 2017; 249:48-54. [PMID: 28867244 DOI: 10.1016/j.ijcard.2017.08.030] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/13/2017] [Accepted: 08/10/2017] [Indexed: 01/12/2023]
Abstract
BACKGROUND Diabetes Mellitus (DM) is an important factor of adverse cardiovascular events in acute ST-segment elevation myocardial infarction (STEMI) patients. Renin-angiotensin-aldosterone system (RAAS) inhibitors is associated with improved clinical outcomes, however, there are limited data comparing the effectiveness of two different RAAS inhibitors in STEMI patients with DM undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). METHODS A total of 3811 eligible STEMI patients with DM were enrolled in Korea Acute Myocardial Infarction Registry (KAMIR). They were stratified into two groups: Angiotensin converting enzyme inhibitors (ACEI) group (n=2691) and angiotensin receptor blockers (ARB) group (n=1120). To adjust baseline confounding factors, we performed propensity score matching (PSM) analysis and evaluated individual and composite major clinical outcomes between the two groups up to 2years. RESULTS After PSM, a total of 1049 well-matched pairs were generated. Baseline clinical, angiographic and procedural characteristics were well-balanced between the two groups. The incidence of death, recurrent myocardial infarction (MI), revascularization and major adverse cardiac events (MACE) were not significantly different between the two groups up to 2years, CONCLUSION: In the present study, ACEI and ARB showed comparable effectiveness and safety on individual and composite clinical outcomes in STEMI patients with DM who underwent successful PCI with DES at least up to 2years.
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Affiliation(s)
- Se Yeon Choi
- Korea University Guro Hospital, Seoul, Republic of Korea; Department of Medicine, Korea University Graduate School, Seoul, Republic of Korea
| | - Byoung Geol Choi
- Korea University Guro Hospital, Seoul, Republic of Korea; Department of Medicine, Korea University Graduate School, Seoul, Republic of Korea
| | - Seung-Woon Rha
- Korea University Guro Hospital, Seoul, Republic of Korea; Department of Medicine, Korea University Graduate School, Seoul, Republic of Korea.
| | - Jae Kyeong Byun
- Korea University Guro Hospital, Seoul, Republic of Korea; Department of Medicine, Korea University Graduate School, Seoul, Republic of Korea
| | - Min Suk Shim
- Korea University Guro Hospital, Seoul, Republic of Korea
| | - Hu Li
- Korea University Guro Hospital, Seoul, Republic of Korea; Department of Medicine, Korea University Graduate School, Seoul, Republic of Korea
| | - Ahmed Mashaly
- Korea University Guro Hospital, Seoul, Republic of Korea
| | - Cheol Ung Choi
- Korea University Guro Hospital, Seoul, Republic of Korea
| | - Chang Gyu Park
- Korea University Guro Hospital, Seoul, Republic of Korea
| | - Hong Seog Seo
- Korea University Guro Hospital, Seoul, Republic of Korea
| | - Dong Joo Oh
- Korea University Guro Hospital, Seoul, Republic of Korea
| | - Myung Ho Jeong
- Chonnam National University Hospital, Gwangju, Republic of Korea
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Ahmed A, Jorna T, Bhandari S. Should We STOP Angiotensin Converting Enzyme Inhibitors/Angiotensin Receptor Blockers in Advanced Kidney Disease? Nephron Clin Pract 2016; 133:147-58. [PMID: 27336470 DOI: 10.1159/000447068] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 05/18/2016] [Indexed: 11/19/2022] Open
Abstract
Chronic kidney disease (CKD) is a worldwide public health problem associated with a high prevalence of cardiovascular disease (CVD) and impaired quality of life. Previous research for preventing loss of glomerular filtration rate (GFR) has focused on reducing blood pressure (BP) and proteinuria. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor antagonists (ARB) are commonly used in patients with early CKD, but their value in advanced CKD (estimated GFR (eGFR) ≤30 ml/min/1.73 m2) is unknown. There remains a debate about the omission of ACEi/ARB in patients with advanced CKD and their use in association with CVD or heart failure. Does the potential gain in eGFR with ACEi/ARB cessation outweigh the potential adverse cardiovascular outcomes? This paper reviews the current literature that addresses this issue. Several controversies are discussed. Although lowering BP reduces cardiovascular events, evidence suggests that ACEi/ARBs are not superior to other antihypertensive agents. There are no studies assessing the benefits of ACEi/ARB therapy in cardiovascular risk reduction in advanced non-dialysis CKD. The STOP ACEi trial will strengthen the evidence base and shed light on the potential merits and dangers of ACEi/ARB use in advanced CKD on renal function and cardiovascular outcomes.
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Affiliation(s)
- Aimun Ahmed
- Renal Department Royal Preston Hospital Lancashire Teaching Hospitals, Preston, UK
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Lin ZF, Wang CY, Shen LJ, Hsiao FY, Lin Wu FL. Statin Use and the Risk for Incident Diabetes Mellitus in Patients with Acute Coronary Syndrome after Percutaneous Coronary Intervention: A Population-Based Retrospective Cohort Study in Taiwan. Can J Diabetes 2016; 40:264-9. [PMID: 26992286 DOI: 10.1016/j.jcjd.2015.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Revised: 11/07/2015] [Accepted: 12/21/2015] [Indexed: 01/08/2023]
Abstract
OBJECTIVES The purpose of this study was to examine the association between statin use by individuals and the risk for incident diabetes mellitus in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI). METHODS We conducted a retrospective cohort study of patients who were hospitalized for ACS between January 1, 2006, and December 31, 2010, and who had undergone PCI (n=30,665); the data were retrieved from the Taiwan National Health Insurance Research Database. A propensity score technique was used to establish a 1:1 matched cohort for statin users and non-statin users (n=9043 for each group). The risk for incident diabetes mellitus in statin users compared to non-statin users for patients with ACS after PCI was estimated by the multivariable Cox proportional hazards regression model. RESULTS Statin use was associated with a significant increase of 27% in the risk for new-onset diabetes mellitus (adjusted hazard ratio [HR] 1.27, 95% CI 1.14 to 1.41) compared to non-statin use in the matched cohort. The matched cohort analysis indicated that almost all individual statins were associated with a statistically significant increase in the risk for new-onset diabetes mellitus compared to those without statin use. CONCLUSIONS Our study indicated an association between increased risk for new-onset diabetes mellitus and statin use. Because the benefits of statins in prevention of morbidity and mortality in patients with ACS are well-established, clinical decision making should not be changed for patients with existing cardiovascular disease in whom statin therapy is recommended.
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Affiliation(s)
- Zhen-Fang Lin
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Chen-Yu Wang
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Jiuan Shen
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan
| | - Fei-Yuan Hsiao
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
| | - Fe-Lin Lin Wu
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
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