International journal of chronic obstructive pulmonary disease · 2018
Comparative effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on the risk of pneumonia and severe exacerbations in patients with COPD.
Сравнительное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Lai Chih-Cheng, Wang Ya-Hui, Wang Cheng-Yi, Wang Hao-Chien, Yu Chong-Jen, Chen Likwang
Аннотация
OBJECTIVES: This study aimed to compare the effects of angiotensin-converting-enzyme inhibitors (ACEis) and angiotensin receptor blockers (ARBs) on the risk of pneumonia and severe exacerbations in patients with COPD.
PATIENTS AND METHODS: All patients with COPD who used ACEis and ARBs for >90 days between 2000 and 2005 were recruited. Pairwise matching (1:1) of the ACEi and ARB groups resulted in two similar subgroups, with 6,226 patients in each. The primary outcomes were pneumonia and COPD exacerbations, and the secondary outcome was death.
RESULTS: During the follow-up period, the incidence of pneumonia was 7.20 per 100 person-years in the ACEi group and 5.89 per 100 person-years in the ARB group. The ACEi group had a higher risk of pneumonia (adjusted hazard ratio [aHR], 1.22; 95% CI, 1.15-1.29) than the ARB group. The incidence of severe exacerbations was 0.65 per person-year for the patients receiving ACEis and 0.52 per person-year for those receiving ARBs. The patients receiving ACEis had a higher risk of severe exacerbations (aHR, 1.19; 95% CI, 1.16-1.21) than those receiving ARBs. Similar trends were noted in terms of severe exacerbations requiring hospitalization (aHR, 1.24; 95% CI, 1.21-1.28) or emergency department visits (aHR, 1.16; 95% CI, 1.13-1.18), pneumonia requiring mechanical ventilation (aHR, 1.35; 95% CI, 1.24-1.47), and mortality (aHR, 1.33; 95% CI, 1.26-1.42).
CONCLUSION: ARBs were associated with lower rates of pneumonia, severe pneumonia, and mortality than ACEis in patients with COPD.
PATIENTS AND METHODS: All patients with COPD who used ACEis and ARBs for >90 days between 2000 and 2005 were recruited. Pairwise matching (1:1) of the ACEi and ARB groups resulted in two similar subgroups, with 6,226 patients in each. The primary outcomes were pneumonia and COPD exacerbations, and the secondary outcome was death.
RESULTS: During the follow-up period, the incidence of pneumonia was 7.20 per 100 person-years in the ACEi group and 5.89 per 100 person-years in the ARB group. The ACEi group had a higher risk of pneumonia (adjusted hazard ratio [aHR], 1.22; 95% CI, 1.15-1.29) than the ARB group. The incidence of severe exacerbations was 0.65 per person-year for the patients receiving ACEis and 0.52 per person-year for those receiving ARBs. The patients receiving ACEis had a higher risk of severe exacerbations (aHR, 1.19; 95% CI, 1.16-1.21) than those receiving ARBs. Similar trends were noted in terms of severe exacerbations requiring hospitalization (aHR, 1.24; 95% CI, 1.21-1.28) or emergency department visits (aHR, 1.16; 95% CI, 1.13-1.18), pneumonia requiring mechanical ventilation (aHR, 1.35; 95% CI, 1.24-1.47), and mortality (aHR, 1.33; 95% CI, 1.26-1.42).
CONCLUSION: ARBs were associated with lower rates of pneumonia, severe pneumonia, and mortality than ACEis in patients with COPD.
Предметные рубрики MeSH
Administrative Claims, HealthcareAgedAngiotensin II Type 1 Receptor BlockersAngiotensin-Converting Enzyme InhibitorsDatabases, FactualDisease ProgressionFemaleHumansIncidenceMaleMiddle AgedPneumoniaPrognosisProportional Hazards ModelsProtective FactorsPulmonary Disease, Chronic ObstructiveRisk AssessmentRisk FactorsTaiwanTime Factors