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The Efficacy of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Men and Women with Heart Failure with Reduced Ejection Fraction.

Record Type:	Electronic resources : Monograph/item
Title/Author:	The Efficacy of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Men and Women with Heart Failure with Reduced Ejection Fraction./
Author:	Wali, Muhammad Ahmer.
Published:	Ann Arbor : ProQuest Dissertations & Theses, : 2020,
Description:	79 p.
Notes:	Source: Masters Abstracts International, Volume: 82-10.
Contained By:	Masters Abstracts International82-10.
Subject:	Gender differences. -
Online resource:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28383852
ISBN:	9798708708588

The Efficacy of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Men and Women with Heart Failure with Reduced Ejection Fraction.
Wali, Muhammad Ahmer.

The Efficacy of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Men and Women with Heart Failure with Reduced Ejection Fraction. - Ann Arbor : ProQuest Dissertations & Theses, 2020 - 79 p.

Source: Masters Abstracts International, Volume: 82-10.

Thesis (M.Sc.)--McGill University (Canada), 2020.

This item must not be sold to any third party vendors.

Background. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are essential to the treatment of heart failure with reduced ejection fraction (HFrEF). However, little data are available to determine whether their efficacy in reducing hospitalizations and mortality may differ between men and women with HFrEF.Purpose. To explore whether differences exist in the efficacy of ACEi/ARBs in HFrEF by sex.Methods. We conducted a pooled analysis of individual data from 4 randomized clinical trials: The Study of Left Ventricular Dysfunction (SOLVD) Treatment, SOLVD Prevention, Candesartan in Heart Failure: Assessment of Morbidity and Mortality (CHARM) Alternative and Added trials. The primary outcome was a composite of death or hospitalization for heart failure. Multivariable analyses were conducted using Cox proportional hazards models, adjusting for confounders, to obtain sex specific hazard ratios (HRs) and the interaction was tested by a sexby- randomized treatment term.Results. Among the 11,373 participants (19% women; mean age 61.5), women were older, with a higher prevalence of type 2 diabetes and hypertension, and a lower prevalence of ischemic heart disease than men regardless of treatment group. The ACEi/ARBs group had a lower incidence of the primary outcome compared to placebo [13.3 vs 16.6 per 100 person-year], with a similar efficacy in both men and women [adjusted-HR men 0.76 vs women 0.88, p-sex-by-drug interaction = 0.12]. However, women were more likely than men to be hospitalized for HF despite treatment [adjusted-HR men 0.65 95%CI 0.54-0.79 vs women 0.82 95%CI 0.74-0.90, p-sex-by-drug interaction = 0.09].Conclusions. The association between ACEi/ARB and the primary outcome of death or HF hospitalization did not differ between men and women. However, women were more likely than men to have HF hospitalizations despite ACEi/ARB treatment. Future trials should include a larger enough sample size of women and men to enable sex-specific recommendations about HF drug efficacy.

ISBN: 9798708708588Subjects--Topical Terms:

3548331
Gender differences.
Subjects--Index Terms:

Angiotensin converting enzyme inhibitors

The Efficacy of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Men and Women with Heart Failure with Reduced Ejection Fraction.
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245 1 4 $a The Efficacy of Angiotensin Converting Enzyme Inhibitors and Angiotensin Receptor Blockers in Men and Women with Heart Failure with Reduced Ejection Fraction.
260 1 $a Ann Arbor : $b ProQuest Dissertations & Theses, $c 2020
300 $a 79 p.
500 $a Source: Masters Abstracts International, Volume: 82-10.
500 $a Advisor: Pilote, Louise.
502 $a Thesis (M.Sc.)--McGill University (Canada), 2020.
506 $a This item must not be sold to any third party vendors.
520 $a Background. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARB) are essential to the treatment of heart failure with reduced ejection fraction (HFrEF). However, little data are available to determine whether their efficacy in reducing hospitalizations and mortality may differ between men and women with HFrEF.Purpose. To explore whether differences exist in the efficacy of ACEi/ARBs in HFrEF by sex.Methods. We conducted a pooled analysis of individual data from 4 randomized clinical trials: The Study of Left Ventricular Dysfunction (SOLVD) Treatment, SOLVD Prevention, Candesartan in Heart Failure: Assessment of Morbidity and Mortality (CHARM) Alternative and Added trials. The primary outcome was a composite of death or hospitalization for heart failure. Multivariable analyses were conducted using Cox proportional hazards models, adjusting for confounders, to obtain sex specific hazard ratios (HRs) and the interaction was tested by a sexby- randomized treatment term.Results. Among the 11,373 participants (19% women; mean age 61.5), women were older, with a higher prevalence of type 2 diabetes and hypertension, and a lower prevalence of ischemic heart disease than men regardless of treatment group. The ACEi/ARBs group had a lower incidence of the primary outcome compared to placebo [13.3 vs 16.6 per 100 person-year], with a similar efficacy in both men and women [adjusted-HR men 0.76 vs women 0.88, p-sex-by-drug interaction = 0.12]. However, women were more likely than men to be hospitalized for HF despite treatment [adjusted-HR men 0.65 95%CI 0.54-0.79 vs women 0.82 95%CI 0.74-0.90, p-sex-by-drug interaction = 0.09].Conclusions. The association between ACEi/ARB and the primary outcome of death or HF hospitalization did not differ between men and women. However, women were more likely than men to have HF hospitalizations despite ACEi/ARB treatment. Future trials should include a larger enough sample size of women and men to enable sex-specific recommendations about HF drug efficacy.
520 $a Contexte. Les inhibiteurs de l'enzyme de conversion de l'angiotensine (ACEi) et les inhibiteurs des recepteurs de l'angiotensine (ARB) sont essentiels au traitement de l'insuffisance cardiaque avec fraction d'ejection reduite (HFrEF). Cependant, peu de donnees sont disponibles pour determiner si leur efficacite peut differer entre les hommes et les femmes atteints de HFrEF. Objectif. Explorer s'il existe des differences dans l'efficacite des ACEi / ARB dans le HFrEF selon le sexe.Methodes. Nous avons effectue une analyse groupee des donnees individuelles de 4 essais cliniques randomises: The Study of Left Ventricular Dysfunction (SOLVD) Treatment, SOLVD Prevention, Candesartan in Heart Failure: Assessment of Morbidity and Mortality (CHARM) Alternative and Added. Le critere de jugement principal etait un composite de deces et d'hospitalisation pour insuffisance cardiaque. Des analyses multivariables ont ete menees a l'aide des modeles de risques proportionnels de Cox, ajustes pour tenir compte des facteurs confondants, pour obtenir des rapports de risque (HR) specifiques au sexe et l'interaction a ete testee par un terme du traitement randomise et du sexe.Resultats. Parmi les 11373 participants (19% de femmes; age moyen de 61,5 ans), les femmes etaient plus agees, avec une prevalence plus elevee de diabete de type 2 et d'hypertension, et une prevalence plus faible de cardiopathie ischemique que les hommes, quel que soit le groupe de traitement. Le groupe ACEi / ARB avait une incidence plus faible du critere de jugement principal par rapport au placebo [13,3 vs 16,6 pour 100 personnes-an], avec une efficacite similaire chez les hommes et les femmes [HR ajuste hommes 0,76 vs femmes 0,88, p-sexe - interaction medicamenteuse = 0,12]. Cependant, les femmes etaient plus susceptibles que les hommes d'etre hospitalisees pour IC malgre le traitement [HR ajuste pour hommes 0,65 IC a 95% 0,54-0,79 vs femmes 0,82 IC a 95% 0,74-0,90, interaction p sexe par medicament = 0,09]. Conclusions. L'association ACEi / ARB et le critere principal de deces ou d'hospitalisation pour l'insuffisance cardiaque ne differait pas entre les hommes et les femmes. Cependant, les femmes etaient plus susceptibles que les hommes d'avoir des hospitalisations pour l'insufficsance cardiaque malgre le traitement. Les essais futurs devraient inclure un echantillon suffisamment plus grand de femmes et d'hommes pour permettre des recommandations specifiques sur l'efficacite des medicaments contre HFrEF selon le sexe.
590 $a School code: 0781.
650 4 $a Gender differences. $3 3548331
650 4 $a Drug interactions. $3 548667
650 4 $a Epidemiology. $3 568544
650 4 $a Mortality. $3 533218
650 4 $a Ejection fraction. $3 3686270
650 4 $a Heart failure. $3 804127
650 4 $a Manuscripts. $3 3566242
650 4 $a Hypertension. $3 825110
650 4 $a Morbidity. $3 3686271
650 4 $a Women. $3 531755
650 4 $a Enzymes. $3 520899
650 4 $a Hospitalization. $3 825068
653 $a Angiotensin converting enzyme inhibitors
653 $a Angiotensin receptor blockers
653 $a Heart failure
653 $a Reduced ejection fraction
690 $a 0487
690 $a 0564
710 2 $a McGill University (Canada). $3 1018122
773 0 $t Masters Abstracts International $g 82-10.
790 $a 0781
791 $a M.Sc.
792 $a 2020
793 $a English
856 4 0 $u http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=28383852