Rate of Cough During Treatment With Angiotensin‐Converting Enzyme Inhibitors: A Meta‐Analysis of Randomized Placebo‐Controlled Trials. Issue 3 (8th February 2018)

• Record Type: Journal Article
• Authors: Vukadinović, Davor; Vukadinović, Aleksandra Nikolovska; Lavall, Daniel; Laufs, Ulrich; Wagenpfeil, Stefan; Böhm, Michael
• Is Part Of: Clinical pharmacology & therapeutics. Volume 105:Issue 3(2019)
• Page Start: 652
• Page End: 660
• Publication Date: 2018-02-08
• Subjects: Pharmacology -- Periodicals; Therapeutics -- Periodicals; 615.5
• DOI: 10.1002/cpt.1018
• Languages: English
• ISSNs: 0009-9236

Abstract

Abstract : Use of protective angiotensin‐converting enzyme inhibitors (ACE‐I) in patients with cardiovascular disease (CVD) is sometimes limited by incident coughing. In clinical trials, cough occurred also on placebo. We performed a meta‐analysis including randomized, placebo‐controlled trials reporting cough on ACE‐I in patients with CVD. We evaluated the attributable fraction of cough on ACE‐I accounting rate on placebo: placebo‐adjusted ACE‐I (%) = (ACE‐I (%) – Placebo (%)) / ACE‐I (%). In total, 65, 054 patients from 22 included studies were analyzed. Placebo‐adjusted ACE‐I cough was 37% of 13.5% reported cases on ACE‐I, while 8.5% reported cases on placebo were equivalent to 63% of cases on ACE‐I, indicating potential other factors for cough than ACE‐I in a substantial number of cough cases on ACE‐I. Placebo‐adjusted ACE‐I cough had the highest rates of arterial hypertension (85%) and the lowest of heart failure (29%). Therefore, other causes of cough, particularly in heart failure, should be excluded before ACE‐I withdrawal.