| The differential effect of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers with respect to foot ulcer and limb amputation in those with diabetes. | |
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MedLine Citation:
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PMID: 20840518 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Diabetic foot ulcers (DFU) or lower extremity amputation (LEA) are complications of diabetes. In those with diabetes, angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are commonly used to prevent the progression of kidney disease. Recent studies have indicated that angiotensin may affect angiogenesis and wound repair. Our goal was to evaluate in those with diabetes the likelihood of developing a DFU or LEA among users of ACEi or ARB using a retrospective cohort design of general practices in the United Kingdom. We studied 40,342 individuals at least 35 years of age with diabetes who were first prescribed ACEi or ARB between 1995 and 2006. A total of 35,153 individuals were treated with ACEi, 12,437 individuals with ARB, and 7,310 both. The hazard ratio for DFU was 0.50 (95% confidence intervals: 0.43, 0.59), showing an increased risk of DFU for those using ACEi vs. ARB. The hazard ratio for LEA was 0.72 (0.48, 1.01). However, among those with lower extremity peripheral arterial disease the hazard ratio was 0.45 (0.22, 0.91) for the new onset of a LEA. In conclusion, among those with diabetes, exposure to ACEi as compared with ARB increases the risk of developing a DFU or LEA. |
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Authors:
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David J Margolis; Ole Hoffstad; Stephen Thom; Warren Bilker; Arturo R Maldonado; Robert M Cohen; Bruce J Aronow; Timothy Crombleholme |
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Publication Detail:
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Type: Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Wound repair and regeneration : official publication of the Wound Healing Society [and] the European Tissue Repair Society Volume: 18 ISSN: 1524-475X ISO Abbreviation: Wound Repair Regen Publication Date: 2010 Sep-Oct |
Date Detail:
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Created Date: 2010-09-15 Completed Date: 2011-03-01 Revised Date: 2011-09-26 |
Medline Journal Info:
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Nlm Unique ID: 9310939 Medline TA: Wound Repair Regen Country: United States |
Other Details:
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Languages: eng Pagination: 445-51 Citation Subset: IM |
Copyright Information:
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© 2010 by the Wound Healing Society. |
Affiliation:
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Department of Dermatology and Biostatistics and Epidemiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. margo@mail.med.upenn.edu |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Amputation / trends* Angiotensin Receptor Antagonists / therapeutic use* Angiotensin-Converting Enzyme Inhibitors / therapeutic use* Disease Progression England Female Follow-Up Studies Foot Ulcer / drug therapy*, surgery Humans Leg / surgery* Male Middle Aged Retrospective Studies Treatment Outcome Wales |
| Grant Support | |
ID/Acronym/Agency:
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DK-080376/DK/NIDDK NIH HHS; DK074055/DK/NIDDK NIH HHS; DK74361/DK/NIDDK NIH HHS; K24 AR002212-10/AR/NIAMS NIH HHS; K24-AR002212/AR/NIAMS NIH HHS; U18HS016946/HS/AHRQ HHS |
| Chemical | |
Reg. No./Substance:
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0/Angiotensin Receptor Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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