Frequency of Dry Cough as an Adverse Effect in Patients Started on Angiotensin-Converting Enzyme (ACE) Inhibitors Presenting with Acute Coronary Syndrome (ACS) and Heart Failure to MTI-Hayatabad Medical Complex, Peshawar
DOI:
https://doi.org/10.70749/ijbr.v2i02.207Keywords:
ACE Inhibitors, Dry Cough, Acute Coronary Syndrome, Heart Failure, Adverse EffectAbstract
Objective: To determine the frequency of dry cough as an adverse effect in patients initiated on angiotensin-converting enzyme inhibitors (ACE inhibitors) for the management of acute coronary syndrome (ACS) and heart failure (HF).
Methodology: This prospective observational study included 250 patients diagnosed with ACS or HF. Data on demographics, comorbidities, and the incidence of dry cough were collected and analyzed. The patients were followed for 30 days after initiation of ACE inhibitors, and the occurrence of dry cough was documented. Statistical analysis was performed using the chi-square test, with a p-value of <0.05 considered statistically significant.
Results: The overall incidence of dry cough was 14.5% in ACS patients and 8.8% in HF patients. A statistically significant difference in the incidence of dry cough was observed between the two groups (p = 0.03). The higher incidence in ACS patients suggests a stronger predisposition to ACE inhibitor-induced cough in this population. Other clinical factors such as age, smoking status, and comorbidities did not show a significant correlation with cough development.
Conclusion: The study found that dry cough is a frequent adverse effect of ACE inhibitors, particularly in ACS patients. Clinicians should monitor for this side effect and consider alternative therapies if intolerable symptoms occur.
References
Vukadinović D, Böhm M. response to “clinical factors and rate of cough during angiotensin‐converting enzyme inhibitor treatment.” Clin Pharmacol Ther 2019;105:567–567. https://doi.org/10.1002/cpt.1217.
Smith SM, Lee J, Lee S. arb superiority over ace inhibitors in coronary heart disease: an alternative viewpoint. Pharmacotherapy 2019;39:204–6. https://doi.org/10.1002/phar.2216.
Pinto B, Jadhav U, Singhai P, Sadhanandham S, Shah N. acei-induced cough: a review of current evidence and its practical implications for optimal cv risk reduction. Indian Heart J 2020;72:345–50. https://doi.org/10.1016/j.ihj.2020.08.007.
Borghi C, Veronesi M. cough and ace inhibitors: the truth beyond placebo. Clin Pharmacol Ther 2019;105:550–2. https://doi.org/10.1002/cpt.1040.
Yilmaz I. angiotensin-converting enzyme inhibitors induce cough. Turkish Thorac J 2019;20:36–42. https://doi.org/10.5152/TurkThoracJ.2018.18014.
Jamshed F, Jaffry HA, Hanif H, Kumar V, Naz U, Ahmed M, et al. demographic and clinical characteristics of patients presenting with angiotensin-converting enzyme inhibitors induced cough. Cureus 2019. https://doi.org/10.7759/cureus.5624.
Sychev I V., Denisenko NP, Kachanova AA, Lapshtaeva A V., Abdullaev SP, Goncharova LN, et al. clinical signs and medical history as predictors of enalapril-associated dry cough in cardiovascular patients. Saf Risk Pharmacother 2023;11:231–40. https://doi.org/10.30895/2312-7821-2023-11-2-231-240.
Luo J-Q, He F-Z, Luo Z-Y, Wen J-G, Wang L-Y, Sun N-L, et al. rs495828 polymorphism of the abo gene is a predictor of enalapril-induced cough in chinese patients with essential hypertension. Pharmacogenet Genomics 2014;24:306–13. https://doi.org/10.1097/FPC.0000000000000050.
Vukadinović D, Vukadinović AN, Lavall D, Laufs U, Wagenpfeil S, Böhm M. rate of cough during treatment with angiotensin‐converting enzyme inhibitors: a meta‐analysis of randomized placebo‐controlled trials. Clin Pharmacol Ther 2019;105:652–60. https://doi.org/10.1002/cpt.1018.
Hu Y, Liang L, Liu S, Kung JY, Banh HL. angiotensin‐converting enzyme inhibitor induced cough compared with placebo, and other antihypertensives: a systematic review, and network meta‐analysis. J Clin Hypertens 2023;25:661–88. https://doi.org/10.1111/jch.14695.
Sheikh AF, Memon FS, Sahar NU. angiotensin-converting enzyme inhibitors; their efficacy, adverse effects, and the genetic influence on cough they may cause. Mol Med Commun 2022;2:77–88. https://doi.org/10.55627/mmc.002.001.0039.
Lee CJ, Choi B, Pak H, Park JM, Lee JH, Lee S-H. genetic variants associated with adverse events after angiotensin-converting enzyme inhibitor use: replication after gwas-based discovery. Yonsei Med J 2022;63:342. https://doi.org/10.3349/ymj.2022.63.4.342.
Na Takuathung M, Sakuludomkan W, Khatsri R, Dukaew N, Kraivisitkul N, Ahmadmusa B, et al. adverse effects of angiotensin-converting enzyme inhibitors in humans: a systematic review and meta-analysis of 378 randomized controlled trials. Int J Environ Res Public Health 2022;19:8373. https://doi.org/10.3390/ijerph19148373.
Sankaran R, Senguttuvan N, Muralidharan TR, Balakrishnan V, Sadhanandham S, Panchanatham M, et al. comparison of adverse events between ramipril and perindopril in contemporary cardiac practice. Ann Clin Cardiol 2021;3:77–80. https://doi.org/10.4103/ACCJ.ACCJ_12_21.
Coley K, Shepherd DJ, Packer R, John C, Free R, Edward J, et al. genome-wide association study of ace inhibitor-induced cough implicates neuropeptides and shows genetic overlap with chronic dry cough n.d. https://doi.org/10.1101/2022.06.30.22277097.
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