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Titolo:
HEALTH OUTCOMES ASSOCIATED WITH BETA-BLOCKER AND DILTIAZEM TREATMENT OF UNSTABLE ANGINA
Autore:
SMITH NL; REIBER GE; PSATY BM; HECKBERT SR; SISCOVICK DS; RITCHIE JL; EVERY NR; KOEPSELL TD;
Indirizzi:
CARDIOVASC HLTH RES UNIT,1730 MINOR AVE,SUITE 1360 SEATTLE WA 98101 UNIV WASHINGTON,DEPT MED SEATTLE WA 98195
Titolo Testata:
Journal of the American College of Cardiology
fascicolo: 5, volume: 32, anno: 1998,
pagine: 1305 - 1311
SICI:
0735-1097(1998)32:5<1305:HOAWBA>2.0.ZU;2-Q
Fonte:
ISI
Lingua:
ENG
Soggetto:
RANDOMIZED CLINICAL-TRIALS; CALCIUM-CHANNEL BLOCKERS; HEART-FAILURE; MYOCARDIAL-INFARCTION; PHARMACOLOGICAL MANAGEMENT; PROPENSITY SCORE; SILENT ISCHEMIA; UNITED-STATES; METOPROLOL; MORTALITY;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
42
Recensione:
Indirizzi per estratti:
Citazione:
N.L. Smith et al., "HEALTH OUTCOMES ASSOCIATED WITH BETA-BLOCKER AND DILTIAZEM TREATMENT OF UNSTABLE ANGINA", Journal of the American College of Cardiology, 32(5), 1998, pp. 1305-1311

Abstract

Objective. We compared long-term health outcomes associated with betaadrenergic blocking agents and diltiazem treatment for unstable angina. Background. No long-term data have been published comparing these two antianginal treatments in this setting. Methods. Eligible veterans were discharged from the Veterans Affairs Puget Sound Health Care System (VAPSHCS), Seattle Division, between October 1989 and September 1995 with an unstable angina diagnosis and were prescribed monotherapy beta-blocker or diltiazem treatment at discharge, Medication data were collected from medical records and computerized VAPSHCS outpatient pharmacy files, Follow-up death and coronary artery disease rehospitalization data were collected through 1996. Proportional hazards regression compared survival among diltiazem and beta-blocker users, controlling for patient characteristics with propensity scores. Results. TWO hundred forty-seven veterans (24% on beta-blockers, 76% on diltiazem) were included in this study. There were 54 (22%) deaths during an average follow-up of 51 months. After propensity score adjustment, there was nodifference in risk of death comparing diltiazem to beta-blocker treatment (hazards ratios [HR] 1.1; 95% confidence interval [CI] 0.49 to 2.4). Among Washington residents (n = 207), there were 146 (71%) coronary artery disease rehospitalizations or deaths during follow-up. After adjustment, there was a nonsignificant increase in risk of rehospitalization or death associated with diltiazem use (HR 1.4; 95% CI 0.80 to 2.4). For both analyses, similar risks were found among veterans without relative contraindications to beta blockers. Conclusions. We found no survival benefit of diltiazem over beta-blocker treatment for unstable angina in this cohort of veterans. (C) 1998 by the American College of Cardiology.

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Documento generato il 27/11/20 alle ore 01:39:58