Many angiotensin-converting enzyme (ACE) inhibitors have been shown to reduce mortality after acute myocardial infarction (AMI), yet no study has investigated if this is a class effect. Discharge prescription data were analyzed for patients ≥65 years old hospitalized for AMI in Quebec between 1996 and 1998. Among those prescribed an ACE inhibitor (n = 6,287), the association between the specific drug prescribed and mortality following AMI was studied using Cox proportional-hazards models. A propensity score analysis compared short-acting with long-acting ACE inhibitors to account for confounding by indication. / After adjusting for potentially confounding variables, enalapril, fosinopril, and captopril appeared less effective than ramipril at reducing mortality---hazard ratios (and 95% CI): 1.38 (1.01 to 1.89), 1.47 (1.05 to 2.05), and 1.46 (1.05 to 2.03), respectively. Lisinopril appeared to be as effective as ramipril. Short-acting ACE inhibitors were associated with higher mortality than long-acting ACE inhibitors, but only in certain subgroups. / Among patients prescribed an ACE inhibitor following AMI, it appears that the mortality benefits differ according to the specific drug prescribed.
| Identifer | oai:union.ndltd.org:LACETR/oai:collectionscanada.gc.ca:QMM.33832 |
| Date | January 2002 |
| Creators | Rodrigues, Eric John. |
| Contributors | Pilote, Louise (advisor), Paradis, Gilles (advisor) |
| Publisher | McGill University |
| Source Sets | Library and Archives Canada ETDs Repository / Centre d'archives des thèses électroniques de Bibliothèque et Archives Canada |
| Language | English |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
| Format | application/pdf |
| Coverage | Master of Science (Department of Epidemiology and Biostatistics.) |
| Rights | All items in eScholarship@McGill are protected by copyright with all rights reserved unless otherwise indicated. |
| Relation | alephsysno: 001863624, proquestno: MQ78949, Theses scanned by UMI/ProQuest. |
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