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dc.contributor.authorTzeng, Nian-Shengen_US
dc.contributor.authorYin, Yun-Juen_US
dc.contributor.authorLi, Chien-Hsunen_US
dc.contributor.authorChen, Hung-Anen_US
dc.contributor.authorChiu, Shih-Hsiangen_US
dc.contributor.authorHo, Shinn-Yingen_US
dc.contributor.authorHuang, Hui-Lingen_US
dc.date.accessioned2019-04-03T06:36:22Z-
dc.date.available2019-04-03T06:36:22Z-
dc.date.issued2015-10-21en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0140633en_US
dc.identifier.urihttp://hdl.handle.net/11536/128407-
dc.description.abstractBackground Major adverse cardiovascular events (MACE) cause the leading cause of morbidity and mortality in patients with end-stage renal disease (ESRD) on maintenance Hemodialysis (HD) or peritoneal dialysis (PD). Many randomized-controlled trials (RCTs) have proved that angiotensin receptor blockers (ARBs) can reduce the risk of MACE in the people with normal or impaired kidney function without dialysis. This study seeks to clarify whether ARBs therapy could also attenuate this risk in patients with ESRD on maintenance dialysis. Materials and Methods The National Health Research Institute provided a database of one million random subjects for the study. A random sample was taken of 1800 patients >= 18 years y/o with ESRD on dialysis without a history of MACE and use of ARBs within 6-months prior to enrollment. Cox proportional hazard regression analysis was used to identify the risk factors and compute the hazard ratios accompanying 95% confidence intervals. Results In these 1800 patients, 1061 had never used ARBs, while 224 had used them for 1-90 days, and 515 had used them for more than 90 days. We found that ARBs significantly decrease the incidences of acute myocardial infarctions (AMI), coronary artery diseases (CAD) requiring coronary stent or percutaneous transluminal coronary angioplasty (PTCA), peripheral artery disease (PAD) requiring percutaneous transluminal angioplasty (PTA), and acute stroke. Cumulative prescription days of ARBs beyond 365-760 days or more were found to be negatively correlated with incidence of MACEs. For patients with dual comorbidity (i.e., mellitus and hyperlipidemia), 91-365 cumulative prescription days might also attenuate the risk. Conclusions For patients on maintenance dialysis, the use of ARBs could significantly attenuate the risk of major cardiovascular events: AMI, acute stroke, and PAD requiring PTA.en_US
dc.language.isoen_USen_US
dc.titleAngiotensin Receptor Blockers Decrease the Risk of Major Adverse Cardiovascular Events in Patients with End-Stage Renal Disease on Maintenance Dialysis: A Nationwide Matched-Cohort Studyen_US
dc.typeArticleen_US
dc.identifier.doi10.1371/journal.pone.0140633en_US
dc.identifier.journalPLOS ONEen_US
dc.citation.volume10en_US
dc.citation.issue10en_US
dc.citation.spage0en_US
dc.citation.epage0en_US
dc.contributor.department生物科技學系zh_TW
dc.contributor.department生物資訊及系統生物研究所zh_TW
dc.contributor.departmentDepartment of Biological Science and Technologyen_US
dc.contributor.departmentInstitude of Bioinformatics and Systems Biologyen_US
dc.identifier.wosnumberWOS:000363248400064en_US
dc.citation.woscount6en_US
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