國家衛生研究院 NHRI:Item 3990099045/11476
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    Please use this identifier to cite or link to this item: http://ir.nhri.org.tw/handle/3990099045/11476


    Title: Risk of sepsis and mortality among patients with chronic obstructive pulmonary disease treated with angiotensin-converting enzyme inhibitors or angiotensin receptor blockers
    Authors: Lai, CC;Wang, YH;Wang, CY;Wang, HC;Yu, CJ;Chen, LK
    Contributors: Institute of Population Health Sciences
    Abstract: OBJECTIVES: This study aimed to compare the effect of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on the risk and outcomes of sepsis in patients with chronic obstructive pulmonary disease. DESIGN: A retrospective study. SETTING: Taiwan's National Health Insurance Research Database. PATIENTS: All patients with chronic obstructive pulmonary disease who received angiotensin-converting enzyme inhibitors or angiotensin receptor blockers for more than 90 days between 2000 and 2005 were recruited for this study. Pairwise matching (1:1) of the angiotensin-converting enzyme inhibitor and angiotensin receptor blocker groups resulted in two similar subgroups with 5,959 patients in each. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: The primary outcome was sepsis, and the secondary outcome was death. The occurrence rate of sepsis was 3.67 per 100 person-years for the patients receiving angiotensin-converting enzyme inhibitors and 2.87 per 100 person-years for those receiving angiotensin receptor blockers. In addition, the patients receiving angiotensin-converting enzyme inhibitors had a higher risk of septic shock (adjusted hazard ratio, 1.45; 95% CI, 1.26-1.67) and mortality (adjusted hazard ratio, 1.31; 95% CI, 1.22-1.40) than those receiving angiotensin receptor blockers. No matter whether the patients had prior severe exacerbation before the index date, those receiving angiotensin-converting enzyme inhibitors had a higher risk of sepsis, septic shock, and mortality than those receiving angiotensin receptor blockers (all p < 0.001). CONCLUSIONS: Angiotensin receptor blockers were associated with lower rates of sepsis and mortality than angiotensin-converting enzyme inhibitors in the patients with chronic obstructive pulmonary disease. The similar findings were also noted in subgroup analysis.
    Date: 2019-01-01
    Relation: Critical Care Medicine. 2019 Jan 1;47(1):e14-e20.
    Link to: http://dx.doi.org/10.1097/ccm.0000000000003475
    JIF/Ranking 2023: http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=0090-3493&DestApp=IC2JCR
    Cited Times(WOS): https://www.webofscience.com/wos/woscc/full-record/WOS:000457673800005
    Cited Times(Scopus): https://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85058888160
    Appears in Collections:[Li-Kwang Chen] Periodical Articles

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