TY - JOUR
T1 - Pollen Count and Presentation of Angiotensin-Converting Enzyme Inhibitor-Associated Angioedema
AU - Straka, Brittany
AU - Nian, Hui
AU - Sloan, Chantel
AU - Byrd, James Brian
AU - Woodard-Grice, Alencia
AU - Yu, Chang
AU - Stone, Elizabeth
AU - Steven, Gary
AU - Hartert, Tina
AU - Teo, Koon K.
AU - Pare, Guillaume
AU - McCarty, Catherine A.
AU - Brown, Nancy J.
PY - 2013/9
Y1 - 2013/9
N2 - Background: The incidence of angiotensin-converting enzyme (ACE) inhibitor-associated angioedema is increased in patients with seasonal allergies. Objective: We tested the hypothesis that patients with ACE inhibitor-associated angioedema present during months when pollen counts are increased. Methods: Cohort analysis examined the month of presentation of ACE inhibitor-associated angioedema and pollen counts in the ambulatory and hospital setting. Patients with ACE inhibitor-associated angioedema were ascertained through (1) an observational study of patients presenting to Vanderbilt University Medical Center, (2) patients presenting to the Marshfield Clinic and participating in the Marshfield Clinic Personalized Medicine Research Project, and (3) patients enrolled in The Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET). Measurements include date of presentation of ACE inhibitor-associated angioedema, population exposure to ACE inhibitor by date, and local pollen counts by date. Results: At Vanderbilt, the rate of angioedema was significantly associated with tree pollen months (P= .01 from χ2 test). When separate analyses were conducted in patients with a history of seasonal allergies and patients without, the rate of ACE inhibitor-associated angioedema was increased during tree pollen months only in patients with a history of seasonal allergies (P= .002). In Marshfield, the rate of angioedema was significantly associated with ragweed pollen months (P= .025). In ONTARGET, a positive trend was observed between the ACE inhibitor-associated angioedema rate and grass season, although it was not statistically significant (P= .057). Conclusions: Patients with ACE inhibitor-associated angioedema are more likely to present with this adverse drug eventduring months when pollen counts are increased.
AB - Background: The incidence of angiotensin-converting enzyme (ACE) inhibitor-associated angioedema is increased in patients with seasonal allergies. Objective: We tested the hypothesis that patients with ACE inhibitor-associated angioedema present during months when pollen counts are increased. Methods: Cohort analysis examined the month of presentation of ACE inhibitor-associated angioedema and pollen counts in the ambulatory and hospital setting. Patients with ACE inhibitor-associated angioedema were ascertained through (1) an observational study of patients presenting to Vanderbilt University Medical Center, (2) patients presenting to the Marshfield Clinic and participating in the Marshfield Clinic Personalized Medicine Research Project, and (3) patients enrolled in The Ongoing Telmisartan Alone and in Combination with Ramipril Global Endpoint Trial (ONTARGET). Measurements include date of presentation of ACE inhibitor-associated angioedema, population exposure to ACE inhibitor by date, and local pollen counts by date. Results: At Vanderbilt, the rate of angioedema was significantly associated with tree pollen months (P= .01 from χ2 test). When separate analyses were conducted in patients with a history of seasonal allergies and patients without, the rate of ACE inhibitor-associated angioedema was increased during tree pollen months only in patients with a history of seasonal allergies (P= .002). In Marshfield, the rate of angioedema was significantly associated with ragweed pollen months (P= .025). In ONTARGET, a positive trend was observed between the ACE inhibitor-associated angioedema rate and grass season, although it was not statistically significant (P= .057). Conclusions: Patients with ACE inhibitor-associated angioedema are more likely to present with this adverse drug eventduring months when pollen counts are increased.
KW - Angioedema
KW - Angiotensin-converting enzyme inhibitor
KW - Bradykinin
KW - Pollen
KW - Seasonal allergies
KW - Substance P
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UR - http://www.scopus.com/inward/citedby.url?scp=84883451549&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2013.05.003
DO - 10.1016/j.jaip.2013.05.003
M3 - Article
C2 - 24565618
AN - SCOPUS:84883451549
SN - 2213-2198
VL - 1
SP - 468-473.e4
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
IS - 5
ER -