Interaction between enalapril and aspirin on mortality after acute myocardial infarction: subgroup analysis of the Cooperative New Scandinavian Enalapril Survival Study II (CONSENSUS II)

The American Journal of Cardiology
K N NguyenJ Kjekshus

Abstract

The use of angiotensin-converting enzyme (ACE) inhibitors early after an acute myocardial infarction to reduce mortality has been studied in several trials with inconsistent results. Aspirin (ASA) has become a well-documented therapeutic adjunct in patients with coronary heart disease. Attention has recently been focused on a possible interaction between ASA and ACE inhibitors. We therefore reanalyzed data from the Cooperative New Scandinavian Enalapril Survival Study II (CONSENSUS II) to find any evidence of differential effects of the ACE inhibitor enalapril in subgroups defined by use of ASA at baseline. Logistic regression tested the multiplicative interaction. We used Rothman synergy index S, which would be equal to unity under additivity, and less than unity when suggesting antagonism, to examine the postulated interaction with departure from an additive model. Logistic regression showed that the enalapril-ASA interaction term was a significant predictor of mortality at the end of the study (p = 0.047), and was a borderline significant predictor of mortality 30 days after randomization (p = 0.085). The Rothman synergy index S was 0.66 (95% confidence interval 0.46 to 0.94) for mortality at the end of the study, and 0.68 (...Continue Reading

References

Dec 1, 1992·Journal of the American College of Cardiology·D HallW Rudolph

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Citations

Nov 5, 2002·European Journal of Heart Failure·M EchemannUNKNOWN EPICAL Investigators. Epidémiologie de l'Insuffisance Cardiaque Avancée en Lorraine
Aug 11, 2000·European Journal of Heart Failure·D V Cokkinos, P K Toutouzas
Sep 15, 1998·Lancet·J G ClelandP A Poole-Wilson
Sep 1, 2007·Current Treatment Options in Cardiovascular Medicine·Liviu Klein, John B O'connell
Nov 7, 2007·Comprehensive Therapy·David RosenMark G Graham
Jul 26, 2005·Thrombosis Research·Gregory Y H Lip, Irene Chung
Nov 11, 1999·Clinical Cardiology·J M Wilson, J J Ferguson
Sep 28, 2005·Cardiovascular Drugs and Therapy·Iain M MacIntryeJohn J V McMurray
May 10, 2002·The New England Journal of Medicine·Michael S Lauer
Jul 15, 2000·The New England Journal of Medicine·J W Weinsaft
Nov 9, 2000·British Journal of Clinical Pharmacology·S Maxwell, W S Waring
Apr 4, 2001·Journal of Internal Medicine·G Y LipD G Beevers
Feb 2, 2010·Mayo Clinic Proceedings·Gautam V RamaniMandeep R Mehra
Nov 28, 2006·Clinics in Geriatric Medicine·Christopher M O'Connor, Pradeep Arumugham
Nov 28, 2006·Clinics in Geriatric Medicine·Wilbert S Aronow
Nov 16, 2004·European Journal of Heart Failure·Klaus K A Witte, Andrew L Clark
Aug 19, 2003·European Journal of Heart Failure·Eric J VelazquezUNKNOWN VALIANT Investigators
Apr 5, 2003·Acta Neurologica Scandinavica·D W DrosteE B Ringelstein
Aug 26, 2003·Congestive Heart Failure·Marvin A Konstam
Oct 28, 2006·Journal of Thrombosis and Haemostasis : JTH·O Dotsenko, V V Kakkar
Jul 29, 2008·Pharmacotherapy·Anita AireeShannon W Finks
Sep 17, 2008·European Journal of Heart Failure·Tord JuhlinPeter Höglund
Sep 9, 2009·Fundamental & Clinical Pharmacology·Veeran SubramaniamGregory Y H Lip
Jul 13, 2001·The American Journal of Medicine·D J SoletJ F Plehn
Feb 28, 2006·Journal of Cardiac Failure· Heart Failure Society Of America
Nov 22, 2001·Cardiology Clinics·W H Tang, G S Francis

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