Comparative Risk of Angioedema With Sacubitril-Valsartan vs Renin-Angiotensin-Aldosterone Inhibitors.
J Am Coll Cardiol
; 81(4): 321-331, 2023 01 31.
Article
en En
| MEDLINE
| ID: mdl-36697132
ABSTRACT
BACKGROUND:
Data on angioedema risk among sacubitril-valsartan (SV) users in real-world settings are limited.OBJECTIVES:
We sought to evaluate the risk of angioedema among SV new users compared with angiotensin-converting enzyme (ACE) inhibitor and angiotensin-receptor-blocker (ARB) new users separately.METHODS:
We conducted a propensity score-matched cohort study, comparing SV new users (no use of SV, ACE inhibitor, ARB 6 months before) and SV new users with prior use (within 183 or 14 days) of ACE inhibitor or ARB (ACE inhibitor-SV and ARB-SV users; recent ACE inhibitor-SV and recent ARB-SV users, respectively) vs ACE inhibitor and ARB new users separately.RESULTS:
Compared with ACE inhibitor, SV new (HR 0.18; 95% CI 0.11-0.29) and ACE inhibitor-SV users (HR 0.31; 95% CI 0.23-0.43) showed lower risk of angioedema. On the other hand, there was no difference in angioedema risk when SV new users (HR 0.59; 95% CI 0.35-1.01) or ARB-SV users (HR 0.85; 95% CI 0.58-1.26) were compared with ARB new users. Compared with SV new users, ACE inhibitor-SV users (HR 1.62; 95% CI 0.91-2.89) trended toward higher angioedema risk, which intensified when the ACE inhibitor to SV switch occurred within 14 days (recent ACE inhibitor-SV) (HR 1.98; 95% CI 1.11-3.53). Similarly, ARB-SV users (HR 2.03; 95% CI 1.16-3.54) experienced an increased risk compared with SV new users, which intensified for the more recent switchers (recent ARB-SV) (HR 2.45; 95% CI 1.36-4.43).CONCLUSIONS:
We did not observe an increased risk of angioedema among SV new users compared with ACE inhibitor or ARB users. However, there was an increased risk of angioedema among SV users who recently switched from ACE inhibitor or ARB compared with SV new users.Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Inhibidores de la Enzima Convertidora de Angiotensina
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Angioedema
Tipo de estudio:
Etiology_studies
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Incidence_studies
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Observational_studies
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Risk_factors_studies
Límite:
Humans
Idioma:
En
Revista:
J Am Coll Cardiol
Año:
2023
Tipo del documento:
Article