Evidence map›Paper›PMID 36058306›Full record

ArticleThe American journal of medicine2022

Adverse Events After Initiating Angiotensin-Converting Enzyme Inhibitor/Angiotensin II Receptor Blocker Therapy in Individuals with Heart Failure and Multimorbidity.

Mayra Tisminetzky, Jerry H Gurwitz, Grace Tabada, Kristi Reynolds, Stephen P Fortmann, Elisha Garcia, Thu Pham, Robert Goldberg, Alan S Go

Open access · greenAbstract read
In one paragraph

Article in The American journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 48% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Mayra TisminetzkyDivision of Health Systems Science, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester; Division of Geriatric Medicine, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester; Department of Population and Quantitative Health Sciences, Chan Medical School, University of Massachusetts, Worcester. Electronic address: mayra.tisminetzky@umassmed.edu.
Jerry H GurwitzDivision of Health Systems Science, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester; Division of Geriatric Medicine, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester; Department of Population and Quantitative Health Sciences, Chan Medical School, University of Massachusetts, Worcester.
Grace TabadaDivision of Research, Kaiser Permanente Northern California, Oakland, Calif.
Kristi ReynoldsDepartment of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, Calif; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, Calif.
Stephen P FortmannCenter for Health Research, Kaiser Permanente Northwest, Portland Ore.
Elisha GarciaDivision of Health Systems Science, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester.
Thu PhamDivision of Health Systems Science, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester.
Robert GoldbergDivision of Health Systems Science, Department of Medicine, Chan Medical School, University of Massachusetts, Worcester; Department of Population and Quantitative Health Sciences, Chan Medical School, University of Massachusetts, Worcester.
Alan S GoDivision of Research, Kaiser Permanente Northern California, Oakland, Calif; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, Calif; Departments of Epidemiology, Biostatistics and Medicine, University of California, San Francisco; Department of Medicine, Stanford University, Stanford, Calif.
University of Massachusetts Chan Medical School · USKaiser Permanente · USKaiser Permanente Center for Health Research · US

Funding

Preparing For What Is Next With Aducanumab In Real World SettingsR33AG057806 · NIA · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI Christopher Barrett Bowling, Ana Roman Quinones · 2018 to 2026
$9.0M
WORCHESTER HEART ATTACK COMMUNITY SURVEILLANCE STUDYR01HL035434 · NHLBI · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI GOLDBERG, ROBERT JOEL · 1987 to 2014
$7.4M
TRACE-COREU01HL105268 · NHLBI · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI KIEFE, CATARINA I. · 2010 to 2013
$5.8M
Multimorbidity and Treatment-Related Outcomes in Older Heart Failure PatientsR01AG062630 · NIA · UNIV OF MASSACHUSETTS MED SCH WORCESTER · PI TISMINETZKY, MAYRA S. · 2019 to 2022
$2.4M
NHLBI NIH HHS R01 HL035434NHLBI NIH HHS U01 HL105268NIA NIH HHS R01 AG062630NIA NIH HHS R33 AG057806
6 · The paper itself

Abstract

backgroundCurrent clinical practice guidelines recommend routine kidney function and serum potassium testing within 30 days of initiating angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) therapy. However, evidence is lacking on whether routine follow-up testing reduces therapy-related adverse events in adults with heart failure and if multimorbidity influences the association between laboratory testing and these adverse events.

methodsWe conducted a retrospective cohort study among adults with heart failure from 4 US integrated health care delivery systems. Multimorbidity was defined using counts of chronic conditions. Patients with outpatient serum creatinine and potassium tests in the 30 days after starting ACEI or ARB therapy were matched 1:1 to patients without follow-up tests. We evaluated the association of follow-up testing with 30-day all-cause mortality and hospitalization with acute kidney injury or hyperkalemia using Cox regression.

resultsWe identified 3629 matched adults with heart failure initiating ACEI or ARB therapy between January 1, 2005, and December 31, 2012. Follow-up testing was not significantly associated with 30-day all-cause mortality (adjusted hazard ratio [aHR] 0.45, 95% confidence interval [CI] 0.14; 1.39) and hospitalization with hyperkalemia (aHR 0.73, 95% CI, 0.33; 1.61). However, follow-up testing was significantly associated with hospitalization with acute kidney injury (aHR, 1.40, 95% CI, 1.01; 1.94). Interaction between multimorbidity burden and follow-up testing was not statistically significant in any of the outcome models examined.

conclusionsRoutine laboratory monitoring after ACEI or ARB therapy initiation was not associated with risk of 30-day all-cause mortality or hospitalization with hyperkalemia across the spectrum of multimorbidity burden in a cohort of patients with heart failure.

Indexed as

Acute Kidney InjuryHeart FailureHyperkalemiaAdultAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntiviral AgentsHumansMultimorbidityPotassiumRetrospective StudiesAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAntiviral AgentsPotassiumAdverse eventsHeart failureMultimorbidity

Identifiers

PMID36058306
PMCPMC12308770
OpenAlexW4294169488

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.