Full metadata record
DC FieldValueLanguage
dc.contributor.authorLin, Ting-Tseen_US
dc.contributor.authorWu, Cho-Kaien_US
dc.contributor.authorLiao, Min-Tsunen_US
dc.contributor.authorYang, Yao-Hsuen_US
dc.contributor.authorChen, Pau-Chungen_US
dc.contributor.authorYeih, Dong-Fengen_US
dc.contributor.authorLin, Lian-Yuen_US
dc.date.accessioned2019-04-03T06:41:15Z-
dc.date.available2019-04-03T06:41:15Z-
dc.date.issued2017-12-07en_US
dc.identifier.issn1932-6203en_US
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0188720en_US
dc.identifier.urihttp://hdl.handle.net/11536/144194-
dc.description.abstractBackground Rheumatoid arthritis (RA) is regarded as a high risk factor for myocardial infarction. Hypertension is a major modifiable risk factor contributing to increased risk of myocardial infarction (MI). Dual blood pressure (BP)-lowering and anti-inflammatory effect of renin-angiotensinsystem (RAS) inhibitors may possess protective effect from MI in RA population. However, treatment of hypertension with RAS inhibitors and MI in RA population remains unclear. Methods We investigated whether RAS blockade could decrease risk of incident MI in hypertensive patients with RA. We identified patients with RA and hypertension from the Registry for Catastrophic Illness, a nation-wide database encompassing almost all of the RA patients in Taiwan from 1995 to 2008. The primary endpoint was MI and the median duration of follow up was 2,986 days. Propensity score weighting and Cox proportional hazards regression models were used to estimate hazard ratios for MI. Results Among 27,335 subjects, 9.9% received angiotensin-converting enzyme inhibitors (ACEIs), 25.9% received angiotensin II receptor blockers (ARBs) and 20.0% received ACEIs or ARBs alternatively. The incidence of MI significantly decreased in patients treated with ACEIs (hazard ratio 0.707; 95% confidence interval 0.595 - 0.840), ARBs (0.641; 0.550 - 0.747) and ACEIs/ARBs (0.631; 0.539 - 0.739). The protective effect of ACEI or ARB therapy was significantly better in patients taking longer duration. The effect remained robust in subgroup analyses. Conclusions Therapy of ACEIs or ARBs is associated with a lower risk of MI among patients with RA. Hence, hypertension in patients with RA could comprise a compelling indication for RAS inhibitors.en_US
dc.language.isoen_USen_US
dc.titlePrimary prevention of myocardial infarction with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in hypertensive patients with rheumatoid arthritis - A nationwide cohort studyen_US
dc.typeArticleen_US
dc.identifier.doi10.1371/journal.pone.0188720en_US
dc.identifier.journalPLOS ONEen_US
dc.citation.volume12en_US
dc.citation.issue12en_US
dc.citation.spage0en_US
dc.citation.epage0en_US
dc.contributor.department分子醫學與生物工程研究所zh_TW
dc.contributor.departmentInstitute of Molecular Medicine and Bioengineeringen_US
dc.identifier.wosnumberWOS:000417337800038en_US
dc.citation.woscount0en_US
Appears in Collections:Articles


Files in This Item:

  1. e2bf69f3a565e26b2de298da6ddd4048.pdf

If it is a zip file, please download the file and unzip it, then open index.html in a browser to view the full text content.