Abstract NS10: Prevalence of Angioedema in Patients Treated With Rt-PA Within a U.S. National Database
Introduction: Oro-lingual angioedema has been reported to occur in 1 to 5% of AIS patients receiving rt-PA therapy, in small samples with prospective screening. We sought to describe the prevalence and predictors of angioedema within a large administrative database.
Methods: This analysis utilized the Premier database, a representative sampling of US hospitals that includes approximately 15% of hospital discharges, with access to pharmacy records. Study period was fiscal yrs 2006-2010. Patients with primary admitting diagnosis of AIS were included (ICD 9 codes 433.x1, 434.x1, and 436), AIS patients receiving thrombolytics were identified using ICD-9 code 99.10 or pharmacy use (Alteplase, 50 or 100mg vials). Patients with angioedema were identified by code 995.1. Associations between patient demographics and angioedema were assessed using logistic regression.
Results: A total of 257,992 ischemic stroke patients were within the database. These patients were 47 % male, 16% black, and mean age of 71 (SD 14). There were 8792 (3.4%) IS patients treated with rt-PA, these patients were more likely to be younger (mean age 69 (SD 15) vs 71 (14)), white (66% vs 63%) compared to those not treated, p-values <0.01. There were 129 (0.05%) IS patients with angioedema (0.33% in rt-PA treated, vs. .04% in not-treated, p value <0.01). Multivariable model of predictors of angioedema among those patients treated with rt-PA are presented below.
Discussion: Within a large administrative database, we found a much smaller percentage of angioedema reported among rt-PA treated patients than has been previously reported, likely in part due to under-documentation of milder angioedema events. We also found that rt-PA treated women had much higher risk of angioedema than men, which has not been reported previously. Unfortunately, admission medications are not available within this database, so concomitant angiotensin-converting enzyme medication use (a known risk factor for angioedema) is unknown.
Author Disclosures: T. Doellman: None. L. Heitsch: Research Grant; Significant; Emergency Medicine Foundation Career Development Grant. Honoraria; Modest; Genentech. H. Sucharew: None. O. Adeoye: None. S. Ferioli: None. D.O. Kleindorfer: Speakers' Bureau; Modest; Genentech.
- © 2014 by American Heart Association, Inc.