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  Vol. 161 No. 16, September 10, 2001 TABLE OF CONTENTS
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Interaction Between Angiotensin-Converting Enzyme Inhibitors and Aspirin

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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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