Risk of Death in Patients With Coronary Artery Disease Taking Nitrates and Phosphodiesterase-5 Inhibitors
Authors' conclusion
The use of a PDE5i in combination with nitrate medication in men with stable coronary artery disease may pose an increased hazard for cardiovascular morbidity and mortality.
Study context
- Population
- Men with stable CAD (previous myocardial infarction (MI) or revascularization, 2006–2013) treated with nitrates, Sweden
- Participants
- 5,710 vs 55,777
- Exposure
- PDE5i + nitrates vs nitrates alone
- Nitrates + PDE5in = 5,710
- Nitratesn = 55,777reference
- Outcome
- CV outcomes: all-cause, CV and non-CV mortality, MI, HF, cardiac revascularization, major cardiovascular events (MACE)
Methodological detailsnationwide registers (Swedish Patient Register, Prescribed Drug Register), multivariable Cox regression
- Nationwide registers (Swedish Patient Register, Prescribed Drug Register)
- Multivariable Cox regression
Main finding
As reported in the abstract
Nitrates + PDE5i vs NitratesHazard ratio (95% CI)
Mortality
1.39(1.28–1.51)
CV mortality
1.34(1.11–1.62)
non-CV mortality
1.40(1.27–1.54)
MI
1.72(1.55–1.90)
HF
1.67(1.48–1.90)
Cardiac revascularization
1.95(1.78–2.13)
MACE
1.70(1.58–1.83)
Observational data: associations, not effects.
Original publication
Risk of Death in Patients With Coronary Artery Disease Taking Nitrates and Phosphodiesterase-5 Inhibitors. J Am Coll Cardiol. Published 23 January 2024. doi:10.
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