Abhishek S Chitnis, Rajender R Aparasu, Hua Chen, Mark E Kunik, Paul E Schulz, Michael L Johnson
{"title":"使用血管紧张素转换酶抑制剂、血管紧张素受体阻滞剂与心力衰竭患者痴呆症的风险。","authors":"Abhishek S Chitnis, Rajender R Aparasu, Hua Chen, Mark E Kunik, Paul E Schulz, Michael L Johnson","doi":"10.1177/1533317515618799","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To test the effect of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) on reducing the risk of dementia in patients with heart failure (HF).</p><p><strong>Methods: </strong>This retrospective, longitudinal study used a cohort of HF patients identified from a local Medicare advantage prescription drug plan. Multivariable time-dependent Cox model and marginal structural model using inverse-probability-oftreatment weighting were used to estimate the risk of developing dementia. Adjusted dementia rate ratios were estimated among current and former ACEI/ARB users, as compared with nonusers.</p><p><strong>Results: </strong>Using the time-dependent Cox model, the adjusted dementia rate ratios (95% confidence-interval) among current and former users were 0.90(0.70-1.16) and 0.89 (0.71-1.10), respectively. Use of marginal structural model resulted in similar effect estimates for current and former users as compared with the nonusers.</p><p><strong>Conclusion: </strong>This study found no difference in risk of dementia among the current and former users of ACEI/ARB as compared with the nonusers in an already at-risk HF population.</p>","PeriodicalId":7526,"journal":{"name":"American Journal of Alzheimer's Disease & Other Dementias®","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2016-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10852826/pdf/","citationCount":"0","resultStr":"{\"title\":\"Use of Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, and Risk of Dementia in Heart Failure.\",\"authors\":\"Abhishek S Chitnis, Rajender R Aparasu, Hua Chen, Mark E Kunik, Paul E Schulz, Michael L Johnson\",\"doi\":\"10.1177/1533317515618799\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To test the effect of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) on reducing the risk of dementia in patients with heart failure (HF).</p><p><strong>Methods: </strong>This retrospective, longitudinal study used a cohort of HF patients identified from a local Medicare advantage prescription drug plan. Multivariable time-dependent Cox model and marginal structural model using inverse-probability-oftreatment weighting were used to estimate the risk of developing dementia. Adjusted dementia rate ratios were estimated among current and former ACEI/ARB users, as compared with nonusers.</p><p><strong>Results: </strong>Using the time-dependent Cox model, the adjusted dementia rate ratios (95% confidence-interval) among current and former users were 0.90(0.70-1.16) and 0.89 (0.71-1.10), respectively. Use of marginal structural model resulted in similar effect estimates for current and former users as compared with the nonusers.</p><p><strong>Conclusion: </strong>This study found no difference in risk of dementia among the current and former users of ACEI/ARB as compared with the nonusers in an already at-risk HF population.</p>\",\"PeriodicalId\":7526,\"journal\":{\"name\":\"American Journal of Alzheimer's Disease & Other Dementias®\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2016-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10852826/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Alzheimer's Disease & Other Dementias®\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1177/1533317515618799\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2015/12/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Alzheimer's Disease & Other Dementias®","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1177/1533317515618799","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2015/12/24 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
Use of Angiotensin-Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, and Risk of Dementia in Heart Failure.
Objective: To test the effect of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin-receptor blockers (ARBs) on reducing the risk of dementia in patients with heart failure (HF).
Methods: This retrospective, longitudinal study used a cohort of HF patients identified from a local Medicare advantage prescription drug plan. Multivariable time-dependent Cox model and marginal structural model using inverse-probability-oftreatment weighting were used to estimate the risk of developing dementia. Adjusted dementia rate ratios were estimated among current and former ACEI/ARB users, as compared with nonusers.
Results: Using the time-dependent Cox model, the adjusted dementia rate ratios (95% confidence-interval) among current and former users were 0.90(0.70-1.16) and 0.89 (0.71-1.10), respectively. Use of marginal structural model resulted in similar effect estimates for current and former users as compared with the nonusers.
Conclusion: This study found no difference in risk of dementia among the current and former users of ACEI/ARB as compared with the nonusers in an already at-risk HF population.
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