Cited by 175Coagulation, Bradykinin, Polyphosphates, and AngioedemaRenin-Angiotensin System StudiesBlood Pressure and Hypertension Studies

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Meta-analysis of randomized trials of angioedema as an adverse event of renin-angiotensin system inhibitors

Makani, Harikrishna, Messerli, Franz H., Romero, Jorge, Wever-Pinzon, Omar, Korniyenko, Aleksander, Berrios, Ronaldo Sevilla, Bangalore, Sripal·2012·The American Journal of Cardiology

DOI 10.1016/j.amjcard.2012.03.034

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Abstract

Angioedema is a rare, potentially life-threatening adverse event of renin-angiotensin system inhibitors. The objective of the present study was to determine the risk of angioedema from randomized clinical trials. A PubMed/CENTRAL/EMBASE search was made for randomized clinical trials from 1980 to October 2011 in patients on angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or direct renin inhibitor (DRI). Trials with a total number of patients ≥100 and a duration of ≥8 weeks were included for analysis. Incidence of angioedema was pooled by weighing the incident rate of each trial by the inverse of the variance. Twenty-six trials with 74,857 patients in the ACE inhibitor arm with 232,523 person-years of follow-up, 19 trials with 35,479 patients on ARB with 122,293 person-years of follow-up, and 2 trials with 5,141 patients on DRI with 1,735 person-years of follow-up met the inclusion criteria and were included in the analysis. In head-to-head comparison in 7 trials, risk of angioedema with ACE inhibitors was 2.2 times higher than with ARBs (95% confidence interval [CI] 1.5 to 3.3). With ACE inhibitors and ARBs, incidence of angioedema was higher in heart failure trials compared to hypertension or coronary artery disease trials without heart failure (p <0.0001). Weighted incidence of angioedema with ACE inhibitors was 0.30% (95% CI 0.28 to 0.32) compared to 0.11% (95% CI 0.09 to 0.13) with ARBs, 0.13% (95% CI 0.08 to 0.19) with DRIs, and 0.07%…

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Authors: Makani, H., Messerli, F. H., Romero, J., Wever-Pinzon, O., Korniyenko, A., Berrios, R. S., & Bangalore, S.
Affiliations: St. Luke's-Roosevelt Hospital Center (US)
New York University (US)
Corresponding author: Messerli, Franz H.
ORCID: Messerli, Franz H.
Romero, Jorge
Bangalore, Sripal
Venue: The American Journal of Cardiology
Publisher: Elsevier BV
Published: 2012-08
Volume: 110
Issue: 3
Pages: 383-391
ISSN: 0002-9149 (ISSN-L)
DOI: 10.1016/j.amjcard.2012.03.034
OpenAlex: W2095519993
Cited by: 175
References: 65
Citations by year: 2026: 8 · 2025: 10 · 2024: 7 · 2023: 12 · 2022: 10 · 2021: 14 · 2020: 13 · 2019: 11 · 2018: 13 · 2017: 14 · 2016: 13 · 2015: 14 · 2014: 16 · 2013: 17 · 2012: 3
FWCI: 2.11
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The American Journal of Cardiology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Hematology › Coagulation, Bradykinin, Polyphosphates, and Angioedema
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Renin-Angiotensin System Studies
Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords: angioedema, renin-angiotensin system inhibitors, ACE inhibitors, angiotensin receptor blockers, renin inhibitors, adverse drug reactions, heart failure, hypertension, coronary artery disease, drug safety comparison, placebo comparison
MeSH terms: Renin Inhibitors, Angioedema, Angiotensins, Female, Humans, Male, Middle Aged, Renin-Angiotensin System, Randomized Controlled Trials as Topic

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Meta-analysis of randomized trials of angioedema as an adverse event of renin-angiotensin system inhibitors

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