Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers in Patients With Abdominal Aortic Aneurysms

DOI Web Site 被引用文献3件
  • Karl Emil Kristensen
    From the Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (K.E.K., G.H.G., P.R.H.); Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark (C.T.-P.); The National Institute of Public Health, University of Southern Denmark, Odense, Denmark (G.H.G.); Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (M.E.); and Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University...
  • Christian Torp-Pedersen
    From the Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (K.E.K., G.H.G., P.R.H.); Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark (C.T.-P.); The National Institute of Public Health, University of Southern Denmark, Odense, Denmark (G.H.G.); Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (M.E.); and Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University...
  • Gunnar Hilmar Gislason
    From the Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (K.E.K., G.H.G., P.R.H.); Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark (C.T.-P.); The National Institute of Public Health, University of Southern Denmark, Odense, Denmark (G.H.G.); Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (M.E.); and Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University...
  • Martin Egfjord
    From the Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (K.E.K., G.H.G., P.R.H.); Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark (C.T.-P.); The National Institute of Public Health, University of Southern Denmark, Odense, Denmark (G.H.G.); Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (M.E.); and Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University...
  • Henrik Berg Rasmussen
    From the Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (K.E.K., G.H.G., P.R.H.); Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark (C.T.-P.); The National Institute of Public Health, University of Southern Denmark, Odense, Denmark (G.H.G.); Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (M.E.); and Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University...
  • Peter Riis Hansen
    From the Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark (K.E.K., G.H.G., P.R.H.); Institute of Health, Science and Technology, Aalborg University, Aalborg, Denmark (C.T.-P.); The National Institute of Public Health, University of Southern Denmark, Odense, Denmark (G.H.G.); Department of Nephrology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark (M.E.); and Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen University...

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  • Nation-Wide Cohort Study

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<jats:sec> <jats:title>Objective—</jats:title> <jats:p>The renin–angiotensin system is thought to play a pivotal role in the pathogenesis of abdominal aortic aneurysms (AAAs). However, effects of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II type 1 receptor blockers (ARBs) on human AAAs remain unclear. We therefore examined whether treatment with ACEIs or ARBs influenced hard clinical end points in a nation-wide cohort of patients with AAA.</jats:p> </jats:sec> <jats:sec> <jats:title>Approach and Results—</jats:title> <jats:p> All patients diagnosed with AAA during the period 1995 to 2011 were identified from the Danish nation-wide registries. Subjects were divided according to ACEI and ARB treatment status and followed up for an average of 5 years. Study outcomes were evaluated by time-dependent Cox proportional hazard models. Of 9441 patients with AAA, 12.6% were treated with ACEIs and 5.0% received ARBs. Incidence rates of death from AAA per 100 patient-years were 3.7, 3.6, 4.0, and 4.7 for treatment with ACEIs or ARBs, ACEIs, ARBs, and no ACEI/ARB, respectively. Hazard ratios of death from AAA were 0.64 (95% confidence interval, 0.51–0.80; <jats:italic>P</jats:italic> <0.001) for patients receiving ACEIs and 0.65 (95% confidence interval, 0.48–0.88; <jats:italic>P</jats:italic> =0.006) for those receiving ARBs, respectively ( <jats:italic>P</jats:italic> for difference=0.944). The risk of surgery for AAA was significantly reduced in patients receiving ACEIs (hazard ratio, 0.86 [95% confidence interval, 0.74–0.99]; <jats:italic>P</jats:italic> =0.040) but not in patients receiving ARBs (hazard ratio, 1.02 [95% confidence interval, 0.84–1.23]; <jats:italic>P</jats:italic> =0.867; <jats:italic>P</jats:italic> for difference=0.119). </jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions—</jats:title> <jats:p>In this observational study, treatment with ACEIs or ARBs was associated with a comparable reduction in mortality but not in surgery for AAA among patients with AAA. Randomized controlled trials are warranted to confirm these findings.</jats:p> </jats:sec>

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