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The secondary outcome was discontinuation or suspension of ACEI<\/jats:styled-content>\/ARB<\/jats:styled-content> therapy after a visit to a health care provider. The primary risk factors of interest were age, sex, race\/ethnicity, and chronic kidney disease (CKD<\/jats:styled-content>). Cumulative incidence curves and multivariable Fine\u2010Gray proportional hazards models with 95% confidence intervals (CI<\/jats:styled-content>s) were used with death as a competing risk in both intention\u2010to\u2010treat (ITT<\/jats:styled-content>) and as\u2010treated (AT<\/jats:styled-content>) analyses. In the study cohort, 2.8% experienced ARF<\/jats:styled-content>, 0.5% experienced hyperkalemia, and 63.7% discontinued ACEI<\/jats:styled-content>\/ARB<\/jats:styled-content> therapy within 1 year after hospital discharge. Approximately half of the incidence of ARF<\/jats:styled-content> and hyperkalemia occurred within 6 months after hospital discharge, but the cumulative incidence increased after 6 months. Patients older than 85 years had a higher rate of ARF<\/jats:styled-content> (ITT<\/jats:styled-content> hazard ratio [HR<\/jats:styled-content>] 1.15, 95% CI<\/jats:styled-content> 1.04\u20131.28) and hyperkalemia (ITT HR<\/jats:styled-content> 1.33, 95% CI<\/jats:styled-content> 1.05\u20131.68) compared with those aged 65\u201374 years. Patients with baseline CKD<\/jats:styled-content> had higher rates of ARF<\/jats:styled-content> (ITT HR<\/jats:styled-content> 1.61, 95% CI<\/jats:styled-content> 1.42\u20131.82), hyperkalemia (ITT HR<\/jats:styled-content> 1.41, 95% CI<\/jats:styled-content> 1.11\u20131.77), and ACEI<\/jats:styled-content>\/ARB<\/jats:styled-content> therapy discontinuation or suspension (ITT HR<\/jats:styled-content> 1.05, 95% CI<\/jats:styled-content> 1.02\u20131.09).<\/jats:p><\/jats:sec>Conclusion<\/jats:title>We found a low incidence of ARF<\/jats:styled-content> and hyperkalemia in elderly patients treated with ACEI<\/jats:styled-content>s or ARB<\/jats:styled-content>s after AMI<\/jats:styled-content> hospitalization. However, a high rate of treatment discontinuation might prevent a higher rate of occurrence of these events. Long\u2010term careful monitoring of severe adverse events and timely discontinuation of ACEI<\/jats:styled-content>s or ARB<\/jats:styled-content>s among elderly patients with advancing age and CKD<\/jats:styled-content> after an AMI<\/jats:styled-content> is warranted in clinical practice.<\/jats:p><\/jats:sec>","DOI":"10.1002\/phar.2051","type":"journal-article","created":{"date-parts":[[2017,10,23]],"date-time":"2017-10-23T12:24:01Z","timestamp":1508761441000},"page":"29-41","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Incidence of and Risk Factors for Severe Adverse Events in Elderly Patients Taking Angiotensin\u2010Converting Enzyme Inhibitors or Angiotensin II<\/scp> Receptor Blockers after an Acute Myocardial Infarction"],"prefix":"10.1002","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3561-5876","authenticated-orcid":false,"given":"Gang","family":"Fang","sequence":"first","affiliation":[{"name":"Division of Pharmaceutical Outcomes and Policy UNC Eshelman School of Pharmacy The University of North Carolina at Chapel Hill Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Izabela E.","family":"Annis","sequence":"additional","affiliation":[{"name":"Division of Pharmaceutical Outcomes and Policy UNC Eshelman School of Pharmacy The University of North Carolina at Chapel Hill Chapel Hill North Carolina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joel F.","family":"Farley","sequence":"additional","affiliation":[{"name":"Division of Pharmaceutical Outcomes and Policy UNC Eshelman School of Pharmacy The University of North Carolina at Chapel Hill Chapel Hill North 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