| Tissue angiotensin-converting enzyme inhibitors for the prevention of cardiovascular disease in patients with diabetes mellitus without left ventricular systolic dysfunction or clinical evidence of heart failure: a pooled meta-analysis of randomized placebo-controlled clinical trials. | |
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MedLine Citation:
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PMID: 18095949 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: The aim of this study was to determine the role of tissue angiotensin-converting enzyme (ACE) inhibitors in the prevention of cardiovascular disease in patients with diabetes mellitus without left ventricular systolic dysfunction or clinical evidence of heart failure in randomized placebo-controlled clinical trials using pooled meta-analysis techniques. METHODS: Randomized placebo-controlled clinical trials of at least 12 months duration in patients with diabetes mellitus without left ventricular systolic dysfunction or heart failure who had experienced a prior cardiovascular event or were at high cardiovascular risk were selected. A total of 10 328 patients (43 517 patient-years) from four selected trials were used for meta-analysis. Relative risk estimations were made using data pooled from the selected trials and statistical significance was determined using the Chi-squared test (two-sided alpha error <0.05). The number of patients needed to treat was also calculated. RESULTS: Tissue ACE inhibitors significantly reduced the risk of cardiovascular mortality by 14.9% (p = 0.022), myocardial infarction by 20.8% (p = 0.002) and the need for invasive coronary revascularization by 14% (p = 0.015) when compared to placebo. The risk of all-cause mortality also tended to be lower among patients randomized to tissue ACE inhibitors, whereas the risks of stroke and hospitalization for heart failure were not significantly affected. Treating about 65 patients with tissue ACE inhibitors for about 4.2 years would prevent one myocardial infarction, whereas treating about 85 patients would prevent one cardiovascular death. CONCLUSION: Pooled meta-analysis of randomized placebo-controlled trials suggests that tissue ACE inhibitors modestly reduce the risk of myocardial infarction and cardiovascular death and tend to reduce overall mortality in diabetic patients without left ventricular systolic dysfunction or heart failure. |
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Authors:
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S A Saha; J Molnar; R R Arora |
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Publication Detail:
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Type: Journal Article; Meta-Analysis |
Journal Detail:
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Title: Diabetes, obesity & metabolism Volume: 10 ISSN: 1463-1326 ISO Abbreviation: Diabetes Obes Metab Publication Date: 2008 Jan |
Date Detail:
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Created Date: 2007-12-21 Completed Date: 2008-04-11 Revised Date: 2009-11-03 |
Medline Journal Info:
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Nlm Unique ID: 100883645 Medline TA: Diabetes Obes Metab Country: England |
Other Details:
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Languages: eng Pagination: 41-52 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Chicago Medical School-North Chicago VA Medical Center, 3001 Green Bay Road, North Chicago, IL 60064, USA. saha.sandeep@residents.rosalindfranklin.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Angiotensin-Converting Enzyme Inhibitors
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metabolism,
therapeutic use* Diabetic Angiopathies / prevention & control* Female Follow-Up Studies Heart Failure* Humans Male Middle Aged Randomized Controlled Trials as Topic Risk Assessment Risk Factors Treatment Outcome Ventricular Dysfunction, Left* |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin-Converting Enzyme Inhibitors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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