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Interaction Between Angiotensin-Converting Enzyme Inhibitors and Aspirin
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| Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings. |
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In the article by Krumholz et al1
on the interaction of aspirin and angiotensin-converting enzyme (ACE) inhibitors,
the authors concluded that when prescribed together, the mortality rate after
a myocardial infarction is slightly lower than it is when either drug is prescribed
alone, although the added benefit is not statistically significant. They based
their conclusion on the P value of a product term
between both drugs entered in a Cox regression model. Hence, they use a purely
statistical definition of interaction rather than a biological approach. Conclusions
based on this approach of interaction are often misleading, if not incorrect,
because the magnitude or statistical nonsignificance of a product term is
by no means a proof of the absence of interaction.2
We believe that this interaction should be understood as the joint effect
of 2 drugs in the same causal (or preventive) mechanism of a disease.3
We used the data provided . . . [Full Text of this Article]
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