| Impact of combination medical therapy on mortality in vascular surgery patients. | |
| | |
MedLine Citation:
|
PMID: 20394027 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Th use of beta-blockers or statins has been associated with decreased mortality after noncardiac surgery. There are no prior perioperative studies of concurrent use of other cardioprotective drugs. OBJECTIVE: To ascertain whether combinations of aspirin, beta-blockers, statins, and/or angiotensin-converting enzyme (ACE) inhibitors were associated with decreased mortality 6 months after vascular surgery. PATIENTS AND DESIGN: We performed a retrospective cohort study on the 3020 patients who underwent vascular surgery between January 1998 and March 2005 at 5 regional Veterans Affairs (VA) medical centers. The Cochran-Mantel-Haenszel test was used to assess associations with 6-month all-cause mortality for the combination drug exposures compared to no exposure while adjusting for propensity score. RESULTS: Exposure to all 4 of the study drugs compared to none had a propensity-adjusted relative risk (aRR) of 0.52 (95% confidence interval [CI], 0.26-1.01; P = 0.052), number needed to treat (NNT) 19; 3 drugs vs. none, aRR 0.60 (95% CI, 0.38-0.95; P = 0.030), NNT 38; 2 drugs vs. none, aRR 0.68 (95% CI, 0.46-0.99; P = 0.043), NNT 170; and 1 drug vs. none, aRR 0.88 (95% CI, 0.63-1.22; P = 0.445). ACE inhibitor exposure was common in all combinations. CONCLUSIONS: Combination use of 2 to 3 study drugs, some of which included ACE inhibitors, was associated with decreased mortality after vascular surgery. Combination use of all 4 study drugs was not statistically significant due to the small number of events in this group. Further prospective studies of combination perioperative aspirin, beta-blockers, statins, and ACE inhibitors are warranted. |
| | |
Authors:
|
Thomas W Barrett; Kathleen Newton; Caroline Koudelka; Motomi Mori; Leann Radcliffe |
Related Documents
:
|
373517 - The value of atropine in the documentation of reversible airways obstruction. 18316577 - Synergy of a herpes oncolytic virus and paclitaxel for anaplastic thyroid cancer. 23193987 - Scientific considerations for complex drugs in light of established and emerging regula... 16619587 - Ex vivo chemosensitivity of head and neck carcinoma to cytostatic drug combinations. 21967057 - The p-glycoprotein multidrug transporter. 2274577 - The dihydrofolate reductase-thymidylate synthetase gene in the drug resistance of malar... |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. |
Journal Detail:
|
Title: Journal of hospital medicine : an official publication of the Society of Hospital Medicine Volume: 5 ISSN: 1553-5606 ISO Abbreviation: J Hosp Med Publication Date: 2010 Apr |
Date Detail:
|
Created Date: 2010-04-15 Completed Date: 2010-07-28 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 101271025 Medline TA: J Hosp Med Country: United States |
Other Details:
|
Languages: eng Pagination: 218-25 Citation Subset: IM |
Copyright Information:
|
(c) 2010 Society of Hospital Medicine. |
Affiliation:
|
Section of General Medicine, Portland Veterans Affairs VA Medical Center, Portland, Oregon 97207-1034, USA. barretth@ohsu.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Aged Cohort Studies Drug Therapy, Combination / methods* Female Humans Male Middle Aged Outcome Assessment (Health Care) Postoperative Complications / mortality*, prevention & control Retrospective Studies Risk Adjustment Vascular Surgical Procedures* |
| Grant Support | |
ID/Acronym/Agency:
|
UL1 RR024140/RR/NCRR NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Safety and efficacy of continuous insulin infusion in noncritical care settings.
Next Document: Left bundle branch block (LBBB) masks changes due to hyperkalemia: a myth.