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Objectives/Hypothesis
Black race is a risk factor for angioedema. The primary aim was to examine the relationship between race–ethnicity and risk factors for angioedema.
The Laryngoscope
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Laryngology
Case-control study evaluating competing risk factors for angioedema in a high-risk population
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Presented in poster format at the American Laryngological Association Section of the Combined Otolaryngology Section Meeting, Boston, Massachusetts, U.S.A., April 22–26, 2015.This study was supported in part by the National Center for Advancing Translational Sciences (NCATS), component of the National Institutes of Health (NIH), through a Clinical and Translational Science Award (CTSA) (t.j.o. and e.j., grant number UL1 RR025750). This publication was supported by CTSA grant number 5KL2TR001071 from the NCATS, a component of the NIH. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH. The authors have no other funding, financial relationships, or conflicts of interest to disclose.
Abstract
Study Design
Using a retrospective case-control study design, data was extracted with the Clinical Looking Glass utility, a data collection and management tool that captures data from electronic medical record systems within the Montefiore Healthcare System. Cases were emergency department (ED) visits with primary or secondary International Classification of Diseases, Ninth Revision, code diagnoses of angioedema in adults aged ≥ 18 years from January 2008 to December 2013 at three Montefiore centers in Bronx, New York. Controls were a random sampling of adult ED visits during the same period.
Methods
In primary analyses, angiotensin-converting enzyme inhibitor (ACE-I) and black race were evaluated for synergy. The influence of different risk factors in the development of angioedema was evaluated using logistic regression models. Finally, race–ethnicity was further explored by evaluating for effect modification by stratification of models by race–ethnicity categories.
Results
There were 1,247 cases and 6,500 controls randomly selected from a larger control pool. ACE-I use (odds ratio [OR] 3.70, 95% confidence interval [CI] 2.98, 4.60), hypertension (OR 1.88, 95% CI 1.55, 2.29), and black race (OR 2.25, 95% CI 1.86, 2.72) were the strongest risk factors. ACE-I use and black race were not synergistic (OR 1.10, 95% CI 0.80, 1.51). Race–ethnicity was an effect modifier for certain risk factors.
Conclusion
Race–ethnicity acts as an effect modifier for particular angioedema risk factors. The two strongest risk factors, ACE-I use and black race, were not synergistic.
Level of Evidence
3b. Laryngoscope, 126:1823–1830, 2016