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A logistic regression model based on inpatient health records to predict drug-induced liver injury caused by ramipril—An angiotensin-converting enzyme inhibitor

Drug-induced liver injury (DILI) is a rare side effect of angiotensin-converting enzyme inhibitors (ACEIs). Ramipril is a widely used ACE compound because of its effectiveness in the treatment of hypertension and heart failure, as well as its low risk of adverse effects. However, the clinical featur...

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Autores principales: Thi Thu, Phuong Nguyen, Quynh, Mai Ngo Thi, Van, Hung Nguyen, Thanh, Hoi Nguyen, Minh, Khue Pham
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9384991/
https://www.ncbi.nlm.nih.gov/pubmed/35976917
http://dx.doi.org/10.1371/journal.pone.0272786
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author Thi Thu, Phuong Nguyen
Quynh, Mai Ngo Thi
Van, Hung Nguyen
Thanh, Hoi Nguyen
Minh, Khue Pham
author_facet Thi Thu, Phuong Nguyen
Quynh, Mai Ngo Thi
Van, Hung Nguyen
Thanh, Hoi Nguyen
Minh, Khue Pham
author_sort Thi Thu, Phuong Nguyen
collection PubMed
description Drug-induced liver injury (DILI) is a rare side effect of angiotensin-converting enzyme inhibitors (ACEIs). Ramipril is a widely used ACE compound because of its effectiveness in the treatment of hypertension and heart failure, as well as its low risk of adverse effects. However, the clinical features of ramipril, and the risk of DILI, have not been adequately studied. A retrospective cohort study was performed based on data from 3909 inpatients to compare the risk of DILI conferred by ramipril and other ACEIs. A logistic regression model was then constructed and validated against data from 1686 patients using ramipril, of which 117 patients were diagnosed with DILI. The use of ramipril increased the risk of DILI by 2.68 times (odds ratio = 2.68; 95% confident interval (CI):1.96–3.71) compared with the group using other ACEIs. The clinical features of DILI in the ramipril group were similar to those from the ACEI group (P>0.05), except that the ALT level was higher (P<0.05). A logistic regression model including Body mass index (BMI), comorbidity, liver disease, daily dose, alanine aminotransferase (ALT), and alkaline phosphatase (ALP) was built and successfully validated for DILI risk prediction, with the area under the receiver operating characteristic curve of the model of 0.82 (95% CI: 0.752–0.888). We recommend that clinicians should be aware of the levels of ALT and ALP as well as BMI, comorbidities, and liver disease before prescribing ramipril to avoid the risk of DILI in patients.
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spelling pubmed-93849912022-08-18 A logistic regression model based on inpatient health records to predict drug-induced liver injury caused by ramipril—An angiotensin-converting enzyme inhibitor Thi Thu, Phuong Nguyen Quynh, Mai Ngo Thi Van, Hung Nguyen Thanh, Hoi Nguyen Minh, Khue Pham PLoS One Research Article Drug-induced liver injury (DILI) is a rare side effect of angiotensin-converting enzyme inhibitors (ACEIs). Ramipril is a widely used ACE compound because of its effectiveness in the treatment of hypertension and heart failure, as well as its low risk of adverse effects. However, the clinical features of ramipril, and the risk of DILI, have not been adequately studied. A retrospective cohort study was performed based on data from 3909 inpatients to compare the risk of DILI conferred by ramipril and other ACEIs. A logistic regression model was then constructed and validated against data from 1686 patients using ramipril, of which 117 patients were diagnosed with DILI. The use of ramipril increased the risk of DILI by 2.68 times (odds ratio = 2.68; 95% confident interval (CI):1.96–3.71) compared with the group using other ACEIs. The clinical features of DILI in the ramipril group were similar to those from the ACEI group (P>0.05), except that the ALT level was higher (P<0.05). A logistic regression model including Body mass index (BMI), comorbidity, liver disease, daily dose, alanine aminotransferase (ALT), and alkaline phosphatase (ALP) was built and successfully validated for DILI risk prediction, with the area under the receiver operating characteristic curve of the model of 0.82 (95% CI: 0.752–0.888). We recommend that clinicians should be aware of the levels of ALT and ALP as well as BMI, comorbidities, and liver disease before prescribing ramipril to avoid the risk of DILI in patients. Public Library of Science 2022-08-17 /pmc/articles/PMC9384991/ /pubmed/35976917 http://dx.doi.org/10.1371/journal.pone.0272786 Text en © 2022 Thi Thu et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Thi Thu, Phuong Nguyen
Quynh, Mai Ngo Thi
Van, Hung Nguyen
Thanh, Hoi Nguyen
Minh, Khue Pham
A logistic regression model based on inpatient health records to predict drug-induced liver injury caused by ramipril—An angiotensin-converting enzyme inhibitor
title A logistic regression model based on inpatient health records to predict drug-induced liver injury caused by ramipril—An angiotensin-converting enzyme inhibitor
title_full A logistic regression model based on inpatient health records to predict drug-induced liver injury caused by ramipril—An angiotensin-converting enzyme inhibitor
title_fullStr A logistic regression model based on inpatient health records to predict drug-induced liver injury caused by ramipril—An angiotensin-converting enzyme inhibitor
title_full_unstemmed A logistic regression model based on inpatient health records to predict drug-induced liver injury caused by ramipril—An angiotensin-converting enzyme inhibitor
title_short A logistic regression model based on inpatient health records to predict drug-induced liver injury caused by ramipril—An angiotensin-converting enzyme inhibitor
title_sort logistic regression model based on inpatient health records to predict drug-induced liver injury caused by ramipril—an angiotensin-converting enzyme inhibitor
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9384991/
https://www.ncbi.nlm.nih.gov/pubmed/35976917
http://dx.doi.org/10.1371/journal.pone.0272786
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