Management of the Patient with Stable Ischemic Heart Disease and Preserved Left Ventricular Systolic Function
Patient Discussion: Other Treatments
The patient points out that the guide refers to drugs called ARBs as well as ACEIs. He mentions that if taking an ACEI is good, why are you not prescribing an ARB as well as an ACEI?
Discussion of answers:
A.Incorrect. The addition of a combination of ACEI/ARB to standard therapy for patients with stable ischemic heart disease has no clinical benefits and is associated with increased harms.
B.Incorrect. Results from the ONTARGET trial indicate that ACEIs do not significantly differ from ARBs in any measured clinical outcome.
C.Correct. Available evidence indicates there are no clinical benefits and a significant increase in harms for an ACEI/ARB combination in this patient population.
D.Incorrect. Available evidence indicates there are no clinical benefits and a significant increase in harms for an ACEI/ARB combination in this patient population.
- “ACE Inhibitors” and “ARBs” To Protect Your Heart? A Guide for Patients Being Treated for Stable Coronary Heart Disease. Rockville, MD: Agency for Healthcare Research and Quality. AHRQ Pub. No. 10-EHC002-A. May 2010.
- Coleman CI, Baker WL, Kluger J, et al. Comparative Effectiveness of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II-Receptor Blockers Added to Standard Medical Therapy for Treating Stable Ischemic Heart Disease. Comparative Effectiveness Review No. 18 (Prepared by the University of Connecticut/Hartford Hospital Evidence-based Practice Center under Contract No. 290-2007-10067-I). Rockville, MD: Agency for Healthcare Research and Quality; October 2009.
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