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Effects of metoprolol vs verapamil in patients with stable angina pectoris: The Angina Prognosis Study in Stockholm (APSIS)
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1996 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 17, no 1, 76-81 p.Article in journal (Refereed) Published
Abstract [en]

Objective To study long-term treatment effects of metoprolol or verapamil on combined cardiovascular end points and psychological variables in patients with stable angina pectoris. Design Randomized, double-blind, double-dummy trial. Patients The study included 809 patients under 70 years of age with stable angina pectoris. The mean age of the patients was 59 +/- 7 years and 31% were women. Exclusion criteria were myocardial infarction within the previous 3 years and contraindications to beta-blockers and calcium antagonists. The patients were followed between 6 and 75 months (median 3.4 years and a total of 2887 patient years). Intervention The patients were treated with either metoprolol (Seloken ZOC 200 mg o.d.) or verapamil (Isoptin Retard 240 b.i.d.). Acetylsalicylic acid, ACE inhibitors, lipid lowering drugs and long acting nitrates were allowed in the study. End points Death, non-fatal cardiovascular events including acute myocardial infarction, incapacitating or unstable angina, cerebrovascular or peripheral vascular events. Psychological variables reflecting quality of life i.e. psychosomatic symptoms, sleep disturbances and an evaluation of overall life satisfaction. Results Combined cardiovascular events did not differ and occurred in 30.8% and 29.3% of metoprolol and verapamil treated patients respectively. Total mortality in metoprolol and verapamil treated patients was 5.4 and 6.2%, respectively. Cardiovascular mortality was 4.7% in both groups. Non-fatal cardiovascular events occurred in 26.1 and 24.3% of metoprolol and verapamil-treated patients, respectively. Psychosomatic symptoms and sleep disturbances were significantly improved in both treatment groups. The magnitudes of change were small and did not differ between treatments. Life satisfaction did not change on either drug. Withdrawals due to side effects occurred in 11.1 and 14.6%, respectively. Conclusion This long term study indicates that both drugs are well tolerated and that no difference was shown on the effect on mortality, cardiovascular end points and measures of quality of life.

Place, publisher, year, edition, pages
1996. Vol. 17, no 1, 76-81 p.
Identifiers
URN: urn:nbn:se:kth:diva-24301ISI: A1996UA01000012OAI: oai:DiVA.org:kth-24301DiVA: diva2:346446
Note
QC20100901Available from: 2010-09-01 Created: 2010-09-01 Last updated: 2010-09-01Bibliographically approved
In thesis
1. Risk, Risk Analysis and Decision-making with Reference to Biostatistics and the Field of Medicine
Open this publication in new window or tab >>Risk, Risk Analysis and Decision-making with Reference to Biostatistics and the Field of Medicine
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Risk, risk analysis and decision-making are essential aspects of health care andmedicine, for patients as well as for physicians and for society as a whole, andthe concept of risk and risk analysis in decision-making has a long history. Theword risk has many different interpretations and has no commonly accepteddefinition. In this thesis, we shall let risk stand for the combination of randomor uncertain events with negative consequences for human health, life and/orwelfare and/or the environment together with some measures of the likelihoodof such events. We believe this is the dominant concept and understanding ofrisk, the risk being the likelihood or probability of an event followed by somenegative consequences or activities of that event.

In this doctoral thesis, we focus on biostatistics, risks and risk analysis in thefield of medicine, a science which has been using methods from the area of riskanalysis for a long time. The seven papers (paper I - paper VII) presented inthis thesis, together with a general introduction to risk, risk analysis anddecision-making, will be used to illustrate and discuss risk analysis as a tool fordecision-making in the field of medicine. From my point a view, risk analysisin the field of medicine aims to reduce pain, raise the quality of life, reduce therisk of adverse events, compare cost efficiency between different treatmentregimes and prolong a healthy life. Based on results presented in the thesis, weconclude that biostatistics, risks and risk analysis used in the field of medicineare valuable methods for evaluation of hypotheses within the health care areaand a good basis for decision-making.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2010. 51 p.
Series
TRITA-TEC-PHD, ISSN 1653-4468 ; 10:004
Keyword
risk analysis, risk, consequence, system, biostatistics, decision, decision-making, health care, medicine
National Category
Medical Laboratory and Measurements Technologies
Identifiers
urn:nbn:se:kth:diva-24304 (URN)978-91-85539-62-8 (ISBN)
Public defence
2010-09-15, F3, Lindstedtsvägen 26, KTH, Stockholm, 10:15 (English)
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Note

QC 20100901

Available from: 2010-09-01 Created: 2010-09-01 Last updated: 2017-02-22Bibliographically approved

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