title: 5α-Reductase inhibitors increase acute coronary syndrome risk in patients with benign prostate hyperplasia.
abstract: BACKGROUND
  This study explored the possible association between the use of two typical 5ARIs (finasteride and dutasteride) and the risk of acute coronary syndrome (ACS) in patients with benign prostate hyperplasia (BPH).
  
  
  METHODS
  From the claims data of the Taiwan National Health Insurance (NHI) Taiwan, we identified 1843 ACS cases among BPH patients and randomly selected 7330 controls without ACS, with a similar mean age of 73 years. Multivariate logistic regression analysis estimated the odds ratio (OR) and 95 % confidence interval (CI) for the relationship between the 5ARIs medications and ACS risk.
  
  
  RESULTS
  We found that BPH patients who had received treatment with both finasteride and dutasteride were at a higher risk of ACS with an OR of 3.47 (95 % CI 1.05-11.5), compared to patients without 5ARIs treatment. Furthermore, the dosage analysis showed that there were no significant associations between ACS risk and uses of a single drug medication regardless the dosages. The ORs for those who took only dutasteride were 1.07 (95 % CI 0.39-2.99) with low dose and 0.73 (95 % CI 0.38-1.44) with high dose. The ORs for those who took only finasteride were 1.30 (95 % CI 0.89-1.92) with low dose and 0.98 (95 % CI 0.19-5.13) with high dose.
  
  
  CONCLUSIONS
  This population-based nested case-control study suggests that 5ARI use may increase ACS risk among patients with BPH when patients were exposed to both finasteride and dutasteride.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Changhua Christian Hospital, Yunlin Branch, Yunlin, Taiwan.
authors.forename: C-H
authors.initials: CH
authors.lastname: Chou
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
authors.forename: C-L
authors.initials: CL
authors.lastname: Lin
authors.affiliation: Department of Nuclear Medicine, E-DA Hospital, Kaohsiung, Taiwan.
authors.forename: M-C
authors.initials: MC
authors.lastname: Lin
authors.affiliation: Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan. fcsung@mail.cmu.edu.tw.|Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taiwan. fcsung@mail.cmu.edu.tw.
authors.forename: F-C
authors.initials: FC
authors.lastname: Sung
authors.affiliation: Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, No. 2, Yuh-Der Road, Taichung, 40447, Taiwan. d10040@mail.cmuh.org.tw.|Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan. d10040@mail.cmuh.org.tw.
authors.forename: C-H
authors.initials: CH
authors.lastname: Kao
mesh_terms: D058891:5-alpha Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D054058:Acute Coronary Syndrome / Q000139:chemically induced* / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D004359:Drug Therapy, Combination; D000068538:Dutasteride / Q000008:administration & dosage / Q000009:adverse effects*; D018120:Finasteride / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs / Q000706:statistics & numerical data; D016017:Odds Ratio; D011470:Prostatic Hyperplasia / Q000188:drug therapy* / Q000453:epidemiology; D012306:Risk; D013624:Taiwan / Q000453:epidemiology
chemical_list: D058891:5-alpha Reductase Inhibitors; D018120:Finasteride; D000068538:Dutasteride
keywords: 5-Alpha-reductase inhibitors; Acute coronary syndrome; Benign prostate hyperplasia