2011/03/31 抄録会用論文資料(別生)

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Association of Candesartan vs Losartan With All-Cause Mortality in Patients With Heart Failure

1. Maria Eklind-Cervenka, MD;
2. Lina Benson, MSc;
3. Ulf Dahlström, MD, PhD;
4. Magnus Edner, MD, PhD;
5. Mårten Rosenqvist, MD, PhD;
6. Lars H. Lund, MD, PhD

Abstract

Context Angiotensin II receptor blockers (ARBs) reduce combined mortality and hospitalization in patients with heart failure (HF) with reduced left ventricular ejection fraction. Different agents have different affinity for the AT1 receptor and may have different clinical effects, but have not been tested against each other in HF.

Objective To assess the association of candesartan vs losartan with all-cause mortality in patients with HF.

Design, Setting, and Patients An HF registry (the Swedish Heart Failure Registry) of 30 254 unique patients registered from 62 hospitals and 60 outpatient clinics between 2000 and 2009. A total of 5139 patients (mean [SD] age, 74 [11] years; 39% women) were treated with candesartan (n = 2639) or losartan (n = 2500). Survival as of December 14, 2009, by ARB agent was analyzed by Kaplan-Meier method and predictors of survival determined by univariate and multivariate proportional hazard regression models, with and without adjustment for propensity scores and interactions. Stratified analyses and quantification of residual confounding were also performed.

Main Outcome Measures All-cause mortality at 1 and 5 years.

Results One-year survival was 90% (95% confidence interval [CI], 89%-91%) for patients receiving candesartan and 83% (95% CI, 81%-84%) for patients receiving losartan, and 5-year survival was 61% (95% CI, 54%-68%) and 44% (95% CI, 41%-48%), respectively (log-rank P

Conclusion In this registry of patients with HF, the use of candesartan compared with losartan was associated with a lower mortality risk.

原文リンク
http://jama.ama-assn.org/content/305/2/175.short

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出典は
JAMA. 2011 Jan 12;305(2):175-82.
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このページは、別生 伸太郎が2011年3月30日 11:34に書いたブログ記事です。

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