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Association between guideline recommended drugs and death in older adults with multiple chronic conditions: population based cohort study.

Tinetti ME, McAvay G, Trentalange M, Cohen AB, Allore HG - BMJ (2015)

Bottom Line: Population based cohort study.Among cardiovascular drugs, β blockers, calcium channel blockers, RAS blockers, and statins were associated with reduced mortality for indicated conditions.None of clopidogrel, metformin, or SSRIs/SNRIs was associated with reduced mortality.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine (Geriatrics), Yale School of Medicine, New Haven, CT 06520, USA mary.tinetti@yale.edu.

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Related in: MedlinePlus

Fig 2 Adjusted hazard ratios of death associated with commonly used guideline recommended drugs for older adults with chronic conditions. AF=atrial fibrillation; CAD=coronary artery disease; DEP=depression; DM=diabetes; HF=heart failure; HL=hyperlipidemia; HTN=hypertension; SSRIs= selective serotonin reuptake inhibitors; SNRIs=serotonin norepinephrine reuptake inhibitors. Hazard ratios are adjusted for the covariates described in the Methods section as well asnumber of drugs other than the study drug and all coexisting study conditions and drugs
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fig2: Fig 2 Adjusted hazard ratios of death associated with commonly used guideline recommended drugs for older adults with chronic conditions. AF=atrial fibrillation; CAD=coronary artery disease; DEP=depression; DM=diabetes; HF=heart failure; HL=hyperlipidemia; HTN=hypertension; SSRIs= selective serotonin reuptake inhibitors; SNRIs=serotonin norepinephrine reuptake inhibitors. Hazard ratios are adjusted for the covariates described in the Methods section as well asnumber of drugs other than the study drug and all coexisting study conditions and drugs

Mentions: Figure 2 displays the association between each of clopidogrel, metformin, SSRIs or SNRIs, and warfarin and risk of death for participants with the conditions for which these drugs are recommended. Clopidogrel was not associated with a reduced risk of death in participants with atrial fibrillation or coronary artery disease nor was metformin in those with diabetes or SSRIs or SNRIs among participants with depression. Warfarin was associated with a reduction in death among those with atrial fibrillation (adjusted hazard ratio 0.69, 95% confidence interval 0.56 to 0.85) and thromboembolic disease (0.44, 0.30 to 0.62). The association between warfarin and risk of death was attenuated in participants with atrial fibrillation who had coexisting conditions, particularly depression, hypertension, and hyperlipidemia. The number of people with thromboembolic disease was insufficient to look at combinations of coexisting conditions.


Association between guideline recommended drugs and death in older adults with multiple chronic conditions: population based cohort study.

Tinetti ME, McAvay G, Trentalange M, Cohen AB, Allore HG - BMJ (2015)

Fig 2 Adjusted hazard ratios of death associated with commonly used guideline recommended drugs for older adults with chronic conditions. AF=atrial fibrillation; CAD=coronary artery disease; DEP=depression; DM=diabetes; HF=heart failure; HL=hyperlipidemia; HTN=hypertension; SSRIs= selective serotonin reuptake inhibitors; SNRIs=serotonin norepinephrine reuptake inhibitors. Hazard ratios are adjusted for the covariates described in the Methods section as well asnumber of drugs other than the study drug and all coexisting study conditions and drugs
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4591503&req=5

fig2: Fig 2 Adjusted hazard ratios of death associated with commonly used guideline recommended drugs for older adults with chronic conditions. AF=atrial fibrillation; CAD=coronary artery disease; DEP=depression; DM=diabetes; HF=heart failure; HL=hyperlipidemia; HTN=hypertension; SSRIs= selective serotonin reuptake inhibitors; SNRIs=serotonin norepinephrine reuptake inhibitors. Hazard ratios are adjusted for the covariates described in the Methods section as well asnumber of drugs other than the study drug and all coexisting study conditions and drugs
Mentions: Figure 2 displays the association between each of clopidogrel, metformin, SSRIs or SNRIs, and warfarin and risk of death for participants with the conditions for which these drugs are recommended. Clopidogrel was not associated with a reduced risk of death in participants with atrial fibrillation or coronary artery disease nor was metformin in those with diabetes or SSRIs or SNRIs among participants with depression. Warfarin was associated with a reduction in death among those with atrial fibrillation (adjusted hazard ratio 0.69, 95% confidence interval 0.56 to 0.85) and thromboembolic disease (0.44, 0.30 to 0.62). The association between warfarin and risk of death was attenuated in participants with atrial fibrillation who had coexisting conditions, particularly depression, hypertension, and hyperlipidemia. The number of people with thromboembolic disease was insufficient to look at combinations of coexisting conditions.

Bottom Line: Population based cohort study.Among cardiovascular drugs, β blockers, calcium channel blockers, RAS blockers, and statins were associated with reduced mortality for indicated conditions.None of clopidogrel, metformin, or SSRIs/SNRIs was associated with reduced mortality.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine (Geriatrics), Yale School of Medicine, New Haven, CT 06520, USA mary.tinetti@yale.edu.

Show MeSH
Related in: MedlinePlus