Rates and predictors of ACE inhibitor discontinuation subsequent to elevated serum creatinine: a retrospective cohort study
| Autor: | Freny Vaghaiwalla Mody, Joyce Wong, Cynthia A. Jackevicius, Manyee Gee, Irina Aroustamian |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male medicine.medical_specialty INTERNAL MEDICINE Renal function Angiotensin-Converting Enzyme Inhibitors behavioral disciplines and activities California Drug Administration Schedule Cohort Studies chemistry.chemical_compound Risk Factors Internal medicine medicine Humans cardiovascular diseases Renal Insufficiency Randomized Controlled Trials as Topic Retrospective Studies Heart Failure Creatinine business.industry Research Retrospective cohort study General Medicine Middle Aged medicine.disease Discontinuation Elevated serum creatinine chemistry Heart failure ACE inhibitor Disease Progression Potassium Female business General practice / Family practice Diabetic Angiopathies Cohort study medicine.drug Follow-Up Studies Glomerular Filtration Rate |
| Zdroj: | BMJ Open |
| ISSN: | 2044-6055 |
| Popis: | Objectives ACE inhibitors (ACEI) are underutilised despite cardiovascular benefits, in part due to concerns of known transient elevations in serum creatinine (SCr) after initiation. Our objectives were to evaluate rates and predictors of ACEI discontinuation after SCr elevation post-ACEI initiation since limited data are available that examine this issue. Setting Primary and tertiary Veterans healthcare system in Los Angeles, California, USA Participants 3039 outpatients initiating an ACEI with a SCr measured within 6 months prior to and approximately 3 months after initiating an ACEI. Patients were divided into three groups (SCr 2). Primary and secondary outcome measures Rates and factors associated with ACEI discontinuation subsequent to SCr elevation after ACEI initiation and for patients with baseline SCr >2 mg/dL, the change in SCr associated with chronic use. Predictors were identified using multivariate logistic regression modelling. Results At 3 months follow-up, for those with an increase in SCr, the mean increase post-ACEI initiation was 26%, ranging from −0.01 mg/dL to 0.42 mg/dL varying according to a level of baseline renal function. ACEI discontinuation was higher in patients with elevated baseline SCr (19/165, 11.5%) compared with those with SCr 2 mg/dL at baseline, despite an acute increase in SCr after ACEI initiation, chronic ACEI use was associated with a decrease in SCr in most patients. |
| Databáze: | OpenAIRE |
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