{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T23:12:51Z","timestamp":1782601971945,"version":"3.54.5"},"reference-count":27,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2014,6,9]],"date-time":"2014-06-09T00:00:00Z","timestamp":1402272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2014,10]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Orolingual angioedema (<jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content>) is an uncommon but potentially life\u2010threatening complication of treatment with recombinant tissue plasminogen activator (rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>; alteplase) during acute ischaemic stroke. This study aimed to determine the incidence of rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\u2010related <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> in an Asian stroke population and the risk of pre\u2010stroke anti\u2010hypertensive drug use for development of this complication.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A multi\u2010center stroke registry was used to identify the pre\u2010stroke medications of acute ischaemic stroke patients receiving intravenous rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> from January 2002 to December 2013. The clinical manifestations of rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\u2010related <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> were recorded and the incidence of this complication was determined. The risks of pre\u2010stroke use of different anti\u2010hypertensive agents for the occurrence of rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\u2010related <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> were determined from this study and from a meta\u2010analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 559 patients received intravenous rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> over a 12\u2010year period. Five patients (two males) developed <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> after rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> administration. The incidence of <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> amongst these patients was 0.89% (95% confidence interval 0.29%\u20132.09%), which was lower than that obtained by meta\u2010analysis (1.9%). Amongst pre\u2010stroke anti\u2010hypertensive medications, angiotensin\u2010converting enzyme (<jats:styled-content style=\"fixed-case\">ACE<\/jats:styled-content>) inhibitors were found in this study to have the highest relative risk for rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\u2010related <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> (17.1; 95% confidence interval 3.0\u201396.9). Meta\u2010analysis also revealed that pre\u2010stroke use of <jats:styled-content style=\"fixed-case\">ACE<\/jats:styled-content> inhibitors was associated with a high relative risk of <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> after intravenous rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> (12.9; 95% confidence interval 4.5\u201337.0).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The incidence of rt\u2010<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>\u2010related <jats:styled-content style=\"fixed-case\">OA<\/jats:styled-content> in the Asian population is lower than that in the Caucasian population. Pre\u2010stroke use of <jats:styled-content style=\"fixed-case\">ACE<\/jats:styled-content> inhibitors significantly increases the risk of this complication.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.12472","type":"journal-article","created":{"date-parts":[[2014,6,9]],"date-time":"2014-06-09T10:21:44Z","timestamp":1402309304000},"page":"1285-1291","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":40,"title":["Orolingual angioedema after alteplase therapy of acute ischaemic stroke: incidence and risk of prior angiotensin\u2010converting enzyme inhibitor use"],"prefix":"10.1111","volume":"21","author":[{"given":"S.\u2010Y.","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Pharmacy National Taiwan University Hospital Taipei"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.\u2010C.","family":"Tang","sequence":"additional","affiliation":[{"name":"Stroke Center and Department of Neurology National Taiwan University Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.\u2010K.","family":"Tsai","sequence":"additional","affiliation":[{"name":"Stroke Center and Department of Neurology National Taiwan University Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.\u2010J.","family":"Yeh","sequence":"additional","affiliation":[{"name":"Stroke Center and Department of Neurology National Taiwan University Hospital Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.\u2010J.","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Department of Neurology National Taiwan University Hospital Yun\u2010Lin Branch Yunlin Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.\u2010W.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurology Landseed Hospital Taoyuan Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.\u2010H.","family":"Chen","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital Hsin\u2010Chu Branch Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.\u2010S.","family":"Yip","sequence":"additional","affiliation":[{"name":"National Taiwan University Hospital Hsin\u2010Chu Branch Hsinchu Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L.\u2010J.","family":"Shen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy National Taiwan University Hospital Taipei"},{"name":"Graduate Institute of Clinical Pharmacy College of Pharmacy National Taiwan University Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.\u2010L. 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