Association of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers With Post-Stroke Pneumonia: A Real-World Retrospective Cohort Study

Tianjin University of Traditional Chinese Medicine

Status: Not yet enrolling

Conditions: Post-stroke Pneumonia

Treatments: Drug: Calcium Channel Blockers; Drug: angiotensin converting enzyme inhibitors; Drug: Angiotensin Receptor Blockers

Study type: Observational

Funder types: Other

Identifiers

NCT07262710

XFan

Details and patient eligibility

About

The goal of this retrospective cohort study is to determine if Angiotensin-Converting Enzyme Inhibitors (ACEIs) and Angiotensin Receptor Blockers (ARBs) can lower the risk of post-stroke pneumonia. With an active comparator, new-user design, we selected new users of Calcium Channel Blockers (CCBs) as the reference group to compare against new users of ACEIs/ARBs.

Enrollment: 13,656 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. Diagnosis of both stroke and hypertension, with the initial diagnosis dates for both conditions falling within the period from January 1, 2016, to December 31, 2024.Definition of Stroke: International Classification of Diseases, 10th Revision (ICD-10) codes I60-I64, or a primary diagnosis of stroke-related conditions in inpatient/outpatient medical records, including but not limited to: cerebral hemorrhage, hemorrhagic stroke, cerebral infarction, ischemic stroke, cerebral ischemia, brainstem infarction.Definition of Hypertension: ICD-10 code I10, or inpatient/outpatient medical records containing diagnostic names such as hypertension, benign hypertension, hypertensive crisis.
2. At least one prescription filled from any of the five major classes of antihypertensive medications: Angiotensin-Converting Enzyme Inhibitors (ACEI), Angiotensin II Receptor Blockers (ARB), Beta-blockers, Calcium Channel Blockers (CCB), or Diuretics. Furthermore, there must be no record of any ACEI, ARB, or CCB prescriptions within the 12 months immediately preceding the first ACEI, ARB, or CCB prescription.
3. Aage ≥18 years.

Exclusion criteria

1. Data anomalies or errors(such as an inaccurately recorded date of death).
2. Concurrent use of two or three drug classes among ACEI, ARB, and CCB at any time.
3. Any recorded diagnosis of pneumonia prior to the initiation of the first antihypertensive medication.Definition of Pneumonia: ICD-10 codes J12-J18 or J69, or inpatient/outpatient medical records containing diagnostic names such as pulmonary infection, pneumonia, lung infection.

Trial design

13,656 participants in 4 patient groups

ACEI-exposed group

Description:

Newly Initiated ACEI

Treatment:

Drug: angiotensin converting enzyme inhibitors

ARB-exposed group

Description:

Newly Initiated ARB

Treatment:

Drug: Angiotensin Receptor Blockers

CCB-exposed group1

Description:

Newly Initiated CCB

Treatment:

Drug: Calcium Channel Blockers

CCB-exposed group2

Description:

Newly Initiated CCB

Treatment:

Drug: Calcium Channel Blockers