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Arrhythmia

Kethryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaram, Laurie A Tomlinson

Type
Disease or Syndrome
ID
PH571
Version ID
1142
Valid event data range
01/04/1997 - 31/03/2014
Sex
Female, Male
Agreement Date
2015-12-31
Coding system
Read codes v2 ICD10 codes
Tags /Collections
ClinicalCodes Repository Phenotype Library

Definition

Objective:

To investigate whether there is an association between use of ACE inhibitors (ACEI) and angiotensin receptor blockers (ARB), and risk of acute kidney injury (AKI).

Design:

A 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.

Participants:

Adults 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.

Main outcome measures:

Incidence 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.

Results:

Among 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).

Conclusions:

Treatment 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.

Publications

  • Kethryn E Mansfield, Dorothea Nitsch, Liam Smeeth, Krishnan Bhaskaram, Laurie A Tomlinson, Renin-angiostensin system blockage and risk of acute kidney injury. 2015.

Clinical Code List

Rows: 65
Code Description Entity type Category Coding System (ICD-10 Read)
14AN.00 h/o: atrial fibrillation res30: Arrhythmia diagnostic Read
14AR.00 history of atrial flutter res30: Arrhythmia diagnostic Read
212R.00 atrial fibrillation resolved res30: Arrhythmia diagnostic Read
327..00 ecg: supraventricular arrhythmia res30: Arrhythmia diagnostic Read
3272 ecg: atrial fibrillation res30: Arrhythmia diagnostic Read
3273 ecg: atrial flutter res30: Arrhythmia diagnostic Read
328..00 ecg: ventricular arrhythmia res30: Arrhythmia diagnostic Read
3282 ecg: ventricular tachycardia res30: Arrhythmia diagnostic Read
328Z.00 ecg: ventricular arrhythmia nos res30: Arrhythmia diagnostic Read
662S.00 atrial fibrillation monitoring res30: Arrhythmia diagnostic Read
6A9..00 atrial fibrillation annual review res30: Arrhythmia diagnostic Read
7936A00 implant intravenous pacemaker for atrial fibrillation res30: Arrhythmia diagnostic Read
8CMW200 atrial fibrillation care pathway res30: Arrhythmia diagnostic Read
8HTy.00 referral to atrial fibrillation clinic res30: Arrhythmia diagnostic Read
9Os..00 atrial fibrillation monitoring administration res30: Arrhythmia diagnostic Read
9Os0.00 atrial fibrillation monitoring first letter res30: Arrhythmia diagnostic Read
9Os1.00 atrial fibrillation monitoring second letter res30: Arrhythmia diagnostic Read
9Os2.00 atrial fibrillation monitoring third letter res30: Arrhythmia diagnostic Read
9Os3.00 atrial fibrillation monitoring verbal invite res30: Arrhythmia diagnostic Read
9Os4.00 atrial fibrillation monitoring telephone invite res30: Arrhythmia diagnostic Read
9hF..00 exception reporting: atrial fibrillation quality indicators res30: Arrhythmia diagnostic Read
9hF1.00 excepted from atrial fibrillation qual indic: inform dissent res30: Arrhythmia diagnostic Read
G559.00 arrhythmogenic right ventricular cardiomyopathy res30: Arrhythmia diagnostic Read
G55A.11 tachycardia-induced cardiomyopathy res30: Arrhythmia diagnostic Read
G56..00 conduction disorders res30: Arrhythmia diagnostic Read
G56..11 conduction disorders of heart res30: Arrhythmia diagnostic Read
G567400 wolff-parkinson-white syndrome res30: Arrhythmia diagnostic Read
G56y.00 other conduction disorders res30: Arrhythmia diagnostic Read
G56y000 lown-ganong-levine syndrome res30: Arrhythmia diagnostic Read
G56zz00 conduction disorders nos res30: Arrhythmia diagnostic Read
G57..00 cardiac dysrhythmias res30: Arrhythmia diagnostic Read
G57..11 cardiac arrhythmias res30: Arrhythmia diagnostic Read
G570.00 paroxysmal supraventricular tachycardia res30: Arrhythmia diagnostic Read
G570000 paroxysmal atrial tachycardia res30: Arrhythmia diagnostic Read
G570100 paroxysmal atrioventricular tachycardia res30: Arrhythmia diagnostic Read
G570200 paroxysmal junctional tachycardia res30: Arrhythmia diagnostic Read
G570300 paroxysmal nodal tachycardia res30: Arrhythmia diagnostic Read
G570z00 paroxysmal supraventricular tachycardia nos res30: Arrhythmia diagnostic Read
G571.00 paroxysmal ventricular tachycardia res30: Arrhythmia diagnostic Read
G571.11 ventricular tachycardia res30: Arrhythmia diagnostic Read
G572.00 paroxysmal tachycardia unspecified res30: Arrhythmia diagnostic Read
G572000 essential paroxysmal tachycardia res30: Arrhythmia diagnostic Read
G572z00 paroxysmal tachycardia nos res30: Arrhythmia diagnostic Read
G573.00 atrial fibrillation and flutter res30: Arrhythmia diagnostic Read
G573000 atrial fibrillation res30: Arrhythmia diagnostic Read
G573100 atrial flutter res30: Arrhythmia diagnostic Read
G573200 paroxysmal atrial fibrillation res30: Arrhythmia diagnostic Read
G573300 non-rheumatic atrial fibrillation res30: Arrhythmia diagnostic Read
G573400 permanent atrial fibrillation res30: Arrhythmia diagnostic Read
G573500 persistent atrial fibrillation res30: Arrhythmia diagnostic Read
G573600 paroxysmal atrial flutter res30: Arrhythmia diagnostic Read
G573z00 atrial fibrillation and flutter nos res30: Arrhythmia diagnostic Read
G574.00 ventricular fibrillation and flutter res30: Arrhythmia diagnostic Read
G574100 ventricular flutter res30: Arrhythmia diagnostic Read
G574z00 ventricular fibrillation and flutter nos res30: Arrhythmia diagnostic Read
G576300 atrial premature depolarization res30: Arrhythmia diagnostic Read
G576400 junctional premature depolarization res30: Arrhythmia diagnostic Read
G576500 ventricular premature depolarization res30: Arrhythmia diagnostic Read
G57y.00 other cardiac dysrhythmias res30: Arrhythmia diagnostic Read
G57y600 nodal rhythm disorder res30: Arrhythmia diagnostic Read
G57y900 supraventricular tachycardia nos res30: Arrhythmia diagnostic Read
G57yA00 re-entry ventricular arrhythmia res30: Arrhythmia diagnostic Read
G57yz00 other cardiac dysrhythmia nos res30: Arrhythmia diagnostic Read
G57z.00 cardiac dysrhythmia nos res30: Arrhythmia diagnostic Read
Gyu5a00 [x]other specified cardiac arrhythmias res30: Arrhythmia diagnostic Read
Rows: 15
Code Description Entity type Category Coding System (ICD-10 Read)
I45.6 pre-excitation syndrome res30: Arrhythmia diagnostic ICD-10
I47 paroxysmal tachycardia res30: Arrhythmia diagnostic ICD-10
I47.0 re-entry ventricular arrhythmia res30: Arrhythmia diagnostic ICD-10
I47.1 supraventricular tachycardia res30: Arrhythmia diagnostic ICD-10
I47.2 ventricular tachycardia res30: Arrhythmia diagnostic ICD-10
I47.9 paroxysmal tachycardia, unspecified res30: Arrhythmia diagnostic ICD-10
I48 atrial fibrillation and flutter res30: Arrhythmia diagnostic ICD-10
I49 other cardiac arrhythmias res30: Arrhythmia diagnostic ICD-10
I49.0 ventricular fibrillation and flutter res30: Arrhythmia diagnostic ICD-10
I49.1 atrial premature depolarization res30: Arrhythmia diagnostic ICD-10
I49.2 junctional premature depolarization res30: Arrhythmia diagnostic ICD-10
I49.3 ventricular premature depolarization res30: Arrhythmia diagnostic ICD-10
I49.4 other and unspecified premature depolarization res30: Arrhythmia diagnostic ICD-10
I49.5 sick sinus syndrome res30: Arrhythmia diagnostic ICD-10
R00.0 tachycardia, unspecified res30: Arrhythmia diagnostic ICD-10

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH571/version/1142/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH571/version/1142/detail/?format=json
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get details of phenotype

details = get_phenotype_detail_by_version('PH571', '1142', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH571/version/1142/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH571/version/1142/export/codes/?format=json
CSV site_root/phenotypes/PH571/version/1142/export/codes/
R Package

# Download here

library(ConceptLibraryClient)


# Connect to API

client = connect_to_API(public=TRUE)


# Get codelists of phenotype

codelists = get_phenotype_code_list('PH571', '1142', api_client=client)

Version History

Version
ID
Name Owner Publish date
1142 Arrhythmia ieuan.scanlon 2021-10-06 currently shown

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