[ { "phenotype_id": "PH571", "phenotype_version_id": 1142, "name": "Arrhythmia", "definition": "Objective: \n\nTo investigate whether there is an association between use of ACE inhibitors (ACEI) and angiotensin receptor blockers (ARB), and risk of acute kidney injury (AKI).\n\n\nDesign: \n\nA time-updated, new-user cohort study among people initiating common antihypertensives (ACEI/ARB, beta-blockers, calcium channel blockers and thiazide diuretics) in primary care between April 1997 and March 2014.\n\n\nParticipants: \n\nAdults initiating antihypertensive drug treatment, with at least one year of registration prior to first prescription, identified from UK primary care practices contributing to the Clinical Practice Research Datalink and eligible for linkage to hospital records data from the Hospital Episode Statistics database.\n\n\nMain outcome measures: \n\nIncidence rate ratio (RR) for first episode of AKI during time exposed to ACEI/ARB compared to time unexposed, estimated using Poisson regression adjusted for age, sex, comorbidities, use of other antihypertensive drugs, and calendar period.\n\n\nResults: \n\nAmong 570,443 participants with a median follow-up of 2.8 years (IQR 0.4 to 7) there were 15,004 first cases of AKI. The overall crude rate of AKI was 6.4/1,000 person years at risk (95% CI 6.30 to 6.50) but varied from 1.63 (1.43 to 1.86) to 662.53 (538.98 to 814.40) depending on, age, comorbidities, and other prescribed drugs. The adjusted RR of AKI during time exposed to ACEI/ARB compared to time unexposed was 1.18 (95% CI 1.13 to 1.23) which was attenuated to 1.12 (95% CI 1.08 to 1.17) after adjustment for non-thiazide diuretic therapy. There was an interaction for the risk of AKI between people using loop diuretics and ACEI/ARB. For those taking loop diuretics, the adjusted RR of AKI during time exposed to ACEI/ARB compared to time unexposed was 0.99 (95% CI 0.92 to 1.06) but it was 1.18 (95% CI 1.13 to 1.24) among people not-exposed to loop diuretics (p<0.001).\n\n\nConclusions: \n\nTreatment with ACEI/ARB alone appears to be associated with a small increase in the rate of AKI which is largely seen among people with low absolute risk of AKI. Among people requiring loop diuretics, who have a high absolute risk of AKI, treatment with ACEI/ARB had no measurable association with AKI.\n\n\n\n\n\n\n\n\n", "implementation": "", "publications": [ { "doi": null, "details": "Kethryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaram, Laurie A Tomlinson, Renin-angiostensin system blockage and risk of acute kidney injury. 2015." } ], "validation": "", "citation_requirements": "", "created": "2021-10-06T16:25:13.960989Z", "author": "Kethryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaram, Laurie A Tomlinson", "collections": [ { "name": "ClinicalCodes Repository", "value": 25 }, { "name": "Phenotype Library", "value": 18 } ], "tags": null, "organisation": null, "world_access": 1, "updated": "2021-10-06T16:25:13.961017Z", "sex": [ { "name": "Both", "value": "3" } ], "type": [ { "name": "Disease or syndrome", "value": "2" } ], "ontology": null, "phenoflowid": "", "data_sources": [ { "name": "CPRD GOLD", "value": 5, "uid": "a29feafa-7bdd-44e9-b977-c9d26425e67f", "url": "https://healthdatagateway.org/en/dataset/694", "datasource_id": 694 }, { "name": "HES Admitted Patient Care data for CPRD GOLD", "value": 9, "uid": "4bcf64a6-f404-4ef4-ae6e-172512ab5f43", "url": "https://healthdatagateway.org/en/dataset/674", "datasource_id": 674 } ], "coding_system": [ { "name": "ICD10 codes", "value": 4 }, { "name": "Read codes v2", "value": 5 } ], "event_date_range": "01/04/1997 - 31/03/2014", "concept_information": [ { "concept_id": 1970, "concept_version_id": 5078, "concept_name": "Arrhythmia - Primary Care", "coding_system": { "id": 5, "name": "Read codes v2", "description": "Read codes v2" }, "phenotype_id": "PH571", "phenotype_version_id": 1142, "phenotype_name": "Arrhythmia", "code_attribute_header": [ "Entity type", "Category", "Coding System (ICD-10 Read)" ], "codes": [ { "code": "14AN.00", "description": "h/o: atrial fibrillation", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "14AR.00", "description": "history of atrial flutter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "212R.00", "description": "atrial fibrillation resolved", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "327..00", "description": "ecg: supraventricular arrhythmia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "3272", "description": "ecg: atrial fibrillation", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "3273", "description": "ecg: atrial flutter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "328..00", "description": "ecg: ventricular arrhythmia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "3282", "description": "ecg: ventricular tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "328Z.00", "description": "ecg: ventricular arrhythmia nos", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "662S.00", "description": "atrial fibrillation monitoring", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "6A9..00", "description": "atrial fibrillation annual review", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "7936A00", "description": "implant intravenous pacemaker for atrial fibrillation", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "8CMW200", "description": "atrial fibrillation care pathway", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "8HTy.00", "description": "referral to atrial fibrillation clinic", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "9hF..00", "description": "exception reporting: atrial fibrillation quality indicators", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "9hF1.00", "description": "excepted from atrial fibrillation qual indic: inform dissent", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "9Os..00", "description": "atrial fibrillation monitoring administration", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "9Os0.00", "description": "atrial fibrillation monitoring first letter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "9Os1.00", "description": "atrial fibrillation monitoring second letter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "9Os2.00", "description": "atrial fibrillation monitoring third letter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "9Os3.00", "description": "atrial fibrillation monitoring verbal invite", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "9Os4.00", "description": "atrial fibrillation monitoring telephone invite", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G559.00", "description": "arrhythmogenic right ventricular cardiomyopathy", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G55A.11", "description": "tachycardia-induced cardiomyopathy", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G56..00", "description": "conduction disorders", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G56..11", "description": "conduction disorders of heart", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G567400", "description": "wolff-parkinson-white syndrome", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G56y.00", "description": "other conduction disorders", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G56y000", "description": "lown-ganong-levine syndrome", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G56zz00", "description": "conduction disorders nos", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G57..00", "description": "cardiac dysrhythmias", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G570.00", "description": "paroxysmal supraventricular tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G570000", "description": "paroxysmal atrial tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G570100", "description": "paroxysmal atrioventricular tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G570200", "description": "paroxysmal junctional tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G570300", "description": "paroxysmal nodal tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G570z00", "description": "paroxysmal supraventricular tachycardia nos", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G571.00", "description": "paroxysmal ventricular tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G57..11", "description": "cardiac arrhythmias", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G571.11", "description": "ventricular tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G572.00", "description": "paroxysmal tachycardia unspecified", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G572000", "description": "essential paroxysmal tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G572z00", "description": "paroxysmal tachycardia nos", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G573.00", "description": "atrial fibrillation and flutter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G573000", "description": "atrial fibrillation", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G573100", "description": "atrial flutter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G573200", "description": "paroxysmal atrial fibrillation", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G573300", "description": "non-rheumatic atrial fibrillation", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G573400", "description": "permanent atrial fibrillation", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G573500", "description": "persistent atrial fibrillation", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G573600", "description": "paroxysmal atrial flutter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G573z00", "description": "atrial fibrillation and flutter nos", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G574.00", "description": "ventricular fibrillation and flutter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G574100", "description": "ventricular flutter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G574z00", "description": "ventricular fibrillation and flutter nos", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G576300", "description": "atrial premature depolarization", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G576400", "description": "junctional premature depolarization", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G576500", "description": "ventricular premature depolarization", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G57y.00", "description": "other cardiac dysrhythmias", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G57y600", "description": "nodal rhythm disorder", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G57y900", "description": "supraventricular tachycardia nos", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G57yA00", "description": "re-entry ventricular arrhythmia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G57yz00", "description": "other cardiac dysrhythmia nos", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "G57z.00", "description": "cardiac dysrhythmia nos", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } }, { "code": "Gyu5a00", "description": "[x]other specified cardiac arrhythmias", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "Read" } } ] }, { "concept_id": 1971, "concept_version_id": 5080, "concept_name": "Arrhythmia - Primary Care", "coding_system": { "id": 4, "name": "ICD10 codes", "description": "ICD10 Codes" }, "phenotype_id": "PH571", "phenotype_version_id": 1142, "phenotype_name": "Arrhythmia", "code_attribute_header": [ "Entity type", "Category", "Coding System (ICD-10 Read)" ], "codes": [ { "code": "I45.6", "description": "pre-excitation syndrome", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I47", "description": "paroxysmal tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I47.0", "description": "re-entry ventricular arrhythmia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I47.1", "description": "supraventricular tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I47.2", "description": "ventricular tachycardia", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I47.9", "description": "paroxysmal tachycardia, unspecified", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I48", "description": "atrial fibrillation and flutter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I49", "description": "other cardiac arrhythmias", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I49.0", "description": "ventricular fibrillation and flutter", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I49.1", "description": "atrial premature depolarization", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I49.2", "description": "junctional premature depolarization", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I49.3", "description": "ventricular premature depolarization", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I49.4", "description": "other and unspecified premature depolarization", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "I49.5", "description": "sick sinus syndrome", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } }, { "code": "R00.0", "description": "tachycardia, unspecified", "attributes": { "Entity type": "res30: Arrhythmia", "Category": "diagnostic", "Coding System (ICD-10 Read)": "ICD-10" } } ] } ], "status": 2, "doi": "https://doi.org/10.48533/zz78-mc53", "is_deleted": null, "publish_status": 2, "owner": "ieuan.scanlon", "template": { "id": 1, "name": "Clinical-Coded Phenotype", "description": "Phenotype definitions that are based on lists of clinical codes, or algorithms using clinical codes.", "version_id": 1 }, "versions": [ { "version_id": 1142, "version_name": "Arrhythmia", "version_date": "2021-10-06T16:25:13.995068Z", "is_published": true, "is_latest": true } ] } ]