Preadmission use of renin-angiotensin blockers and rupture of abdominal aortic aneurysm: A nationwide, population-based study

Holger Wemmelund; Annette Høgh; Heidi H. Hundborg; Søren P. Johnsen; Jes S. Lindholt

doi:10.1002/pds.3913

Preadmission use of renin-angiotensin blockers and rupture of abdominal aortic aneurysm: A nationwide, population-based study

Holger Wemmelund^*, Annette Høgh, Heidi H. Hundborg, Søren P. Johnsen, Jes S. Lindholt

^*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

Abstract

Purpose: Rupture of abdominal aortic aneurysms (rAAA) is associated with high mortality. Use of angiotensin converting enzyme inhibitors (ACE-inhibitors) and angiotensin receptor blockers (ARBs) has been suggested to reduce the risk of rAAA. This nationwide, combined case-control and follow-up study aims to examine the possible impact of preadmission renin-angiotensin system blockade on the risk of rAAA and case fatality following rAAA. Methods: Using Danish healthcare registries, a combined case-control and follow-up study was conducted among all patients with a first-time hospital admission for rAAA and AAA controls without rupture in Denmark from 1996 to 2012. Individual-level data were obtained on preadmission drug use, comorbidity, socioeconomic factors, healthcare services use, and death. Results: The adjusted age-matched and sex-matched odds ratios (adj. OR) were 0.96 (95% confidence interval (CI): 0.85; 1.07) for rAAA for current ACE-inhibitor users and 0.93 (95%CI: 0.79; 1.09) for current ARB users compared with never users. Propensity score-matched analyses yielded similar results for current ACE-inhibitor users (adj. OR: 1.02, 95%CI: 0.88; 1.19) and current ARB users (adj. OR: 1.02, 95%CI: 0.83; 1.26). The total 30-day mortality rate after hospital admission was 61.0% in current ACE-inhibitor users compared with 59.4% in non-ACE-inhibitor users (adjusted mortality rate ratio (adj. MRR) 1.06, 95%CI: 0.94; 1.20) and 58.6% in current ARB users compared with 59.9% in non-ARB users (adj. MRR: 0.96, 95%CI: 0.82; 1.14). Conclusion: Use of renin-angiotensin system blockade was not associated with a lower risk of rAAA or lower case fatality following rAAA.

Originalsprog	Engelsk
Tidsskrift	Pharmacoepidemiology and Drug Safety
Vol/bind	25
Nummer	2
Sider (fra-til)	141-150
Antal sider	10
ISSN	1053-8569
DOI	https://doi.org/10.1002/pds.3913
Status	Udgivet - 28 jan. 2016

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@article{9e1c8da130ea4314a8a93349ce26dbb5,

title = "Preadmission use of renin-angiotensin blockers and rupture of abdominal aortic aneurysm: A nationwide, population-based study",

abstract = "Purpose: Rupture of abdominal aortic aneurysms (rAAA) is associated with high mortality. Use of angiotensin converting enzyme inhibitors (ACE-inhibitors) and angiotensin receptor blockers (ARBs) has been suggested to reduce the risk of rAAA. This nationwide, combined case-control and follow-up study aims to examine the possible impact of preadmission renin-angiotensin system blockade on the risk of rAAA and case fatality following rAAA. Methods: Using Danish healthcare registries, a combined case-control and follow-up study was conducted among all patients with a first-time hospital admission for rAAA and AAA controls without rupture in Denmark from 1996 to 2012. Individual-level data were obtained on preadmission drug use, comorbidity, socioeconomic factors, healthcare services use, and death. Results: The adjusted age-matched and sex-matched odds ratios (adj. OR) were 0.96 (95% confidence interval (CI): 0.85; 1.07) for rAAA for current ACE-inhibitor users and 0.93 (95%CI: 0.79; 1.09) for current ARB users compared with never users. Propensity score-matched analyses yielded similar results for current ACE-inhibitor users (adj. OR: 1.02, 95%CI: 0.88; 1.19) and current ARB users (adj. OR: 1.02, 95%CI: 0.83; 1.26). The total 30-day mortality rate after hospital admission was 61.0% in current ACE-inhibitor users compared with 59.4% in non-ACE-inhibitor users (adjusted mortality rate ratio (adj. MRR) 1.06, 95%CI: 0.94; 1.20) and 58.6% in current ARB users compared with 59.9% in non-ARB users (adj. MRR: 0.96, 95%CI: 0.82; 1.14). Conclusion: Use of renin-angiotensin system blockade was not associated with a lower risk of rAAA or lower case fatality following rAAA.",

keywords = "Abdominal aortic aneurysm, Angiotensin converting enzyme inhibitor, Angiotensin receptor blocker, Pharmacoepidemiology, Prognosis, Risk, Rupture",

author = "Holger Wemmelund and Annette H{\o}gh and Hundborg, {Heidi H.} and Johnsen, {S{\o}ren P.} and Lindholt, {Jes S.}",

year = "2016",

month = jan,

day = "28",

doi = "10.1002/pds.3913",

language = "English",

volume = "25",

pages = "141--150",

journal = "Pharmacoepidemiology and Drug Safety",

issn = "1053-8569",

publisher = "John Wiley and Sons Ltd",

number = "2",

}

Preadmission use of renin-angiotensin blockers and rupture of abdominal aortic aneurysm: A nationwide, population-based study. / Wemmelund, Holger ; Høgh, Annette; Hundborg, Heidi H. et al.
I: Pharmacoepidemiology and Drug Safety, Bind 25, Nr. 2, 28.01.2016, s. 141-150.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Preadmission use of renin-angiotensin blockers and rupture of abdominal aortic aneurysm

T2 - A nationwide, population-based study

AU - Wemmelund, Holger

AU - Høgh, Annette

AU - Hundborg, Heidi H.

AU - Johnsen, Søren P.

AU - Lindholt, Jes S.

PY - 2016/1/28

Y1 - 2016/1/28

N2 - Purpose: Rupture of abdominal aortic aneurysms (rAAA) is associated with high mortality. Use of angiotensin converting enzyme inhibitors (ACE-inhibitors) and angiotensin receptor blockers (ARBs) has been suggested to reduce the risk of rAAA. This nationwide, combined case-control and follow-up study aims to examine the possible impact of preadmission renin-angiotensin system blockade on the risk of rAAA and case fatality following rAAA. Methods: Using Danish healthcare registries, a combined case-control and follow-up study was conducted among all patients with a first-time hospital admission for rAAA and AAA controls without rupture in Denmark from 1996 to 2012. Individual-level data were obtained on preadmission drug use, comorbidity, socioeconomic factors, healthcare services use, and death. Results: The adjusted age-matched and sex-matched odds ratios (adj. OR) were 0.96 (95% confidence interval (CI): 0.85; 1.07) for rAAA for current ACE-inhibitor users and 0.93 (95%CI: 0.79; 1.09) for current ARB users compared with never users. Propensity score-matched analyses yielded similar results for current ACE-inhibitor users (adj. OR: 1.02, 95%CI: 0.88; 1.19) and current ARB users (adj. OR: 1.02, 95%CI: 0.83; 1.26). The total 30-day mortality rate after hospital admission was 61.0% in current ACE-inhibitor users compared with 59.4% in non-ACE-inhibitor users (adjusted mortality rate ratio (adj. MRR) 1.06, 95%CI: 0.94; 1.20) and 58.6% in current ARB users compared with 59.9% in non-ARB users (adj. MRR: 0.96, 95%CI: 0.82; 1.14). Conclusion: Use of renin-angiotensin system blockade was not associated with a lower risk of rAAA or lower case fatality following rAAA.

AB - Purpose: Rupture of abdominal aortic aneurysms (rAAA) is associated with high mortality. Use of angiotensin converting enzyme inhibitors (ACE-inhibitors) and angiotensin receptor blockers (ARBs) has been suggested to reduce the risk of rAAA. This nationwide, combined case-control and follow-up study aims to examine the possible impact of preadmission renin-angiotensin system blockade on the risk of rAAA and case fatality following rAAA. Methods: Using Danish healthcare registries, a combined case-control and follow-up study was conducted among all patients with a first-time hospital admission for rAAA and AAA controls without rupture in Denmark from 1996 to 2012. Individual-level data were obtained on preadmission drug use, comorbidity, socioeconomic factors, healthcare services use, and death. Results: The adjusted age-matched and sex-matched odds ratios (adj. OR) were 0.96 (95% confidence interval (CI): 0.85; 1.07) for rAAA for current ACE-inhibitor users and 0.93 (95%CI: 0.79; 1.09) for current ARB users compared with never users. Propensity score-matched analyses yielded similar results for current ACE-inhibitor users (adj. OR: 1.02, 95%CI: 0.88; 1.19) and current ARB users (adj. OR: 1.02, 95%CI: 0.83; 1.26). The total 30-day mortality rate after hospital admission was 61.0% in current ACE-inhibitor users compared with 59.4% in non-ACE-inhibitor users (adjusted mortality rate ratio (adj. MRR) 1.06, 95%CI: 0.94; 1.20) and 58.6% in current ARB users compared with 59.9% in non-ARB users (adj. MRR: 0.96, 95%CI: 0.82; 1.14). Conclusion: Use of renin-angiotensin system blockade was not associated with a lower risk of rAAA or lower case fatality following rAAA.

KW - Abdominal aortic aneurysm

KW - Angiotensin converting enzyme inhibitor

KW - Angiotensin receptor blocker

KW - Pharmacoepidemiology

KW - Prognosis

KW - Risk

KW - Rupture

UR - http://www.scopus.com/inward/record.url?scp=84947770927&partnerID=8YFLogxK

U2 - 10.1002/pds.3913

DO - 10.1002/pds.3913

M3 - Journal article

C2 - 26817783

AN - SCOPUS:84947770927

SN - 1053-8569

VL - 25

SP - 141

EP - 150

JO - Pharmacoepidemiology and Drug Safety

JF - Pharmacoepidemiology and Drug Safety

IS - 2

ER -

Preadmission use of renin-angiotensin blockers and rupture of abdominal aortic aneurysm: A nationwide, population-based study

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