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Cardiac Failure

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

Type
Disease or Syndrome
ID
PH572
Version ID
1144
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: 104
Code Description Entity type Category Coding System (ICD-10 Read)
14A6.00 h/o: heart failure res30: Cardiac failure diagnostic Read
14AM.00 h/o: heart failure in last year res30: Cardiac failure diagnostic Read
1736 paroxysmal nocturnal dyspnoea res30: Cardiac failure diagnostic Read
1J60.00 suspected heart failure res30: Cardiac failure diagnostic Read
1O1..00 heart failure confirmed res30: Cardiac failure diagnostic Read
388D.00 new york heart assoc classification heart failure symptoms res30: Cardiac failure diagnostic Read
585f.00 echocardiogram shows left ventricular systolic dysfunction res30: Cardiac failure diagnostic Read
585g.00 echocardiogram shows left ventricular diastolic dysfunction res30: Cardiac failure diagnostic Read
661M500 heart failure self-management plan agreed res30: Cardiac failure diagnostic Read
662T.00 congestive heart failure monitoring res30: Cardiac failure diagnostic Read
662W.00 heart failure annual review res30: Cardiac failure diagnostic Read
662f.00 new york heart association classification - class i res30: Cardiac failure diagnostic Read
662g.00 new york heart association classification - class ii res30: Cardiac failure diagnostic Read
662h.00 new york heart association classification - class iii res30: Cardiac failure diagnostic Read
662i.00 new york heart association classification - class iv res30: Cardiac failure diagnostic Read
662p.00 heart failure 6 month review res30: Cardiac failure diagnostic Read
679W100 education about deteriorating heart failure res30: Cardiac failure diagnostic Read
679X.00 heart failure education res30: Cardiac failure diagnostic Read
67D4.00 heart failure information given to patient res30: Cardiac failure diagnostic Read
8B29.00 cardiac failure therapy res30: Cardiac failure diagnostic Read
8CL3.00 heart failure care plan discussed with patient res30: Cardiac failure diagnostic Read
8CMK.00 has heart failure management plan res30: Cardiac failure diagnostic Read
8CMW800 heart failure clinical pathway res30: Cardiac failure diagnostic Read
8CeC.00 preferred place of care for next exacerbation heart failure res30: Cardiac failure diagnostic Read
8H2S.00 admit heart failure emergency res30: Cardiac failure diagnostic Read
8HBE.00 heart failure follow-up res30: Cardiac failure diagnostic Read
8HHb.00 referral to heart failure nurse res30: Cardiac failure diagnostic Read
8HHz.00 referral to heart failure exercise programme res30: Cardiac failure diagnostic Read
8HTL.00 referral to heart failure clinic res30: Cardiac failure diagnostic Read
8HTL000 referral to rapid access heart failure clinic res30: Cardiac failure diagnostic Read
8Hg8.00 discharge from practice nurse heart failure clinic res30: Cardiac failure diagnostic Read
8HgD.00 discharge from heart failure nurse service res30: Cardiac failure diagnostic Read
8Hk0.00 referred to heart failure education group res30: Cardiac failure diagnostic Read
8IE0.00 referral to heart failure education group declined res30: Cardiac failure diagnostic Read
8IE1.00 referral to heart failure exercise programme declined res30: Cardiac failure diagnostic Read
9N0k.00 seen in heart failure clinic res30: Cardiac failure diagnostic Read
9N2p.00 seen by community heart failure nurse res30: Cardiac failure diagnostic Read
9N4s.00 did not attend practice nurse heart failure clinic res30: Cardiac failure diagnostic Read
9N4w.00 did not attend heart failure clinic res30: Cardiac failure diagnostic Read
9N6T.00 referred by heart failure nurse specialist res30: Cardiac failure diagnostic Read
9On..00 left ventricular dysfunction monitoring administration res30: Cardiac failure diagnostic Read
9On0.00 left ventricular dysfunction monitoring first letter res30: Cardiac failure diagnostic Read
9On1.00 left ventricular dysfunction monitoring second letter res30: Cardiac failure diagnostic Read
9On2.00 left ventricular dysfunction monitoring third letter res30: Cardiac failure diagnostic Read
9On3.00 left ventricular dysfunction monitoring verbal invite res30: Cardiac failure diagnostic Read
9On4.00 left ventricular dysfunction monitoring telephone invite res30: Cardiac failure diagnostic Read
9Or..00 heart failure monitoring administration res30: Cardiac failure diagnostic Read
9Or0.00 heart failure review completed res30: Cardiac failure diagnostic Read
9Or1.00 heart failure monitoring telephone invite res30: Cardiac failure diagnostic Read
9Or2.00 heart failure monitoring verbal invite res30: Cardiac failure diagnostic Read
9Or3.00 heart failure monitoring first letter res30: Cardiac failure diagnostic Read
9Or4.00 heart failure monitoring second letter res30: Cardiac failure diagnostic Read
9Or5.00 heart failure monitoring third letter res30: Cardiac failure diagnostic Read
9h1..00 exception reporting: lvd quality indicators res30: Cardiac failure diagnostic Read
9h11.00 excepted from lvd quality indicators: patient unsuitable res30: Cardiac failure diagnostic Read
9h12.00 excepted from lvd quality indicators: informed dissent res30: Cardiac failure diagnostic Read
9hH..00 exception reporting: heart failure quality indicators res30: Cardiac failure diagnostic Read
9hH0.00 excepted heart failure quality indicators: patient unsuitabl res30: Cardiac failure diagnostic Read
9hH1.00 excepted heart failure quality indicators: informed dissent res30: Cardiac failure diagnostic Read
G1yz100 rheumatic left ventricular failure res30: Cardiac failure diagnostic Read
G210.00 malignant hypertensive heart disease res30: Cardiac failure diagnostic Read
G210100 malignant hypertensive heart disease with ccf res30: Cardiac failure diagnostic Read
G211100 benign hypertensive heart disease with ccf res30: Cardiac failure diagnostic Read
G21z100 hypertensive heart disease nos with ccf res30: Cardiac failure diagnostic Read
G230.00 malignant hypertensive heart and renal disease res30: Cardiac failure diagnostic Read
G232.00 hypertensive heart&renal dis wth (congestive) heart failure res30: Cardiac failure diagnostic Read
G234.00 hyperten heart&renal dis+both(congestv)heart and renal fail res30: Cardiac failure diagnostic Read
G400.00 acute cor pulmonale res30: Cardiac failure diagnostic Read
G41z.11 chronic cor pulmonale res30: Cardiac failure diagnostic Read
G554000 congestive cardiomyopathy res30: Cardiac failure diagnostic Read
G554011 congestive obstructive cardiomyopathy res30: Cardiac failure diagnostic Read
G557100 beriberi heart disease res30: Cardiac failure diagnostic Read
G58..00 heart failure res30: Cardiac failure diagnostic Read
G58..11 cardiac failure res30: Cardiac failure diagnostic Read
G580.00 congestive heart failure res30: Cardiac failure diagnostic Read
G580.11 congestive cardiac failure res30: Cardiac failure diagnostic Read
G580.12 right heart failure res30: Cardiac failure diagnostic Read
G580.13 right ventricular failure res30: Cardiac failure diagnostic Read
G580.14 biventricular failure res30: Cardiac failure diagnostic Read
G580000 acute congestive heart failure res30: Cardiac failure diagnostic Read
G580100 chronic congestive heart failure res30: Cardiac failure diagnostic Read
G580200 decompensated cardiac failure res30: Cardiac failure diagnostic Read
G580300 compensated cardiac failure res30: Cardiac failure diagnostic Read
G580400 congestive heart failure due to valvular disease res30: Cardiac failure diagnostic Read
G581.00 left ventricular failure res30: Cardiac failure diagnostic Read
G581.11 asthma - cardiac res30: Cardiac failure diagnostic Read
G581.13 impaired left ventricular function res30: Cardiac failure diagnostic Read
G581000 acute left ventricular failure res30: Cardiac failure diagnostic Read
G582.00 acute heart failure res30: Cardiac failure diagnostic Read
G583.00 heart failure with normal ejection fraction res30: Cardiac failure diagnostic Read
G583.11 hfnef - heart failure with normal ejection fraction res30: Cardiac failure diagnostic Read
G583.12 heart failure with preserved ejection fraction res30: Cardiac failure diagnostic Read
G584.00 right ventricular failure res30: Cardiac failure diagnostic Read
G58z.00 heart failure nos res30: Cardiac failure diagnostic Read
G58z.11 weak heart res30: Cardiac failure diagnostic Read
G58z.12 cardiac failure nos res30: Cardiac failure diagnostic Read
G5y4z00 post cardiac operation heart failure nos res30: Cardiac failure diagnostic Read
G5yy900 left ventricular systolic dysfunction res30: Cardiac failure diagnostic Read
G5yyA00 left ventricular diastolic dysfunction res30: Cardiac failure diagnostic Read
G5yyB00 right ventricular diastolic dysfunction res30: Cardiac failure diagnostic Read
Q48y100 congenital cardiac failure res30: Cardiac failure diagnostic Read
R2y1000 [d]cardiorespiratory failure res30: Cardiac failure diagnostic Read
SP11111 heart failure as a complication of care res30: Cardiac failure diagnostic Read
ZRad.00 new york heart assoc classification heart failure symptoms res30: Cardiac failure diagnostic Read
Rows: 8
Code Description Entity type Category Coding System (ICD-10 Read)
I11.0 hypertensive heart disease with (congestive) heart failure res30: Cardiac failure diagnostic ICD-10
I13.0 hypertensive heart and renal disease with (congestive) heart failure res30: Cardiac failure diagnostic ICD-10
I13.2 hypertensive heart and renal disease with both (congestive) heart failure and renal failure res30: Cardiac failure diagnostic ICD-10
I26.0 pulmonary embolism with mention of acute cor pulmonale res30: Cardiac failure diagnostic ICD-10
I50 heart failure res30: Cardiac failure diagnostic ICD-10
I50.0 congestive heart failure res30: Cardiac failure diagnostic ICD-10
I50.1 left ventricular failure res30: Cardiac failure diagnostic ICD-10
I50.9 heart failure, unspecified res30: Cardiac failure diagnostic ICD-10

API

To Export Phenotype Details:

Format API
XML site_root/api/v1/public/phenotypes/PH572/version/1144/detail/?format=xml
JSON site_root/api/v1/public/phenotypes/PH572/version/1144/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('PH572', '1144', api_client=client)

To Export Phenotype Code List:

Format API
XML site_root/api/v1/public/phenotypes/PH572/version/1144/export/codes/?format=xml
JSON site_root/api/v1/public/phenotypes/PH572/version/1144/export/codes/?format=json
CSV site_root/phenotypes/PH572/version/1144/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('PH572', '1144', api_client=client)

Version History

Version
ID
Name Owner Publish date
1144 Cardiac Failure ieuan.scanlon 2021-10-06 currently shown

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