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Letters Co-trimoxazole and sudden death with RAS inhibitors

Link between co-trimoxazole and sudden death in patients receiving inhibitors of renin-angiotensin system could be due to confounding

BMJ 2014; 349 doi: (Published 18 November 2014) Cite this as: BMJ 2014;349:g6899
  1. Henk Scheper, fellow in infectious diseases1,
  2. Willem M Lijfering, clinical epidemiologist1
  1. 1Leiden University Medical Centre, 2333ZA Leiden, Netherlands
  1. H.scheper{at}

Fralick and colleagues’ case-control study investigated whether elderly people receiving renin angiotensin (RAS) inhibitors are at increased risk of death within 7-14 days of starting treatment with co-trimoxazole.1 However, their results could be flawed by confounding by indication. After extensive adjustment with a propensity score, co-trimaxozole users had a 1.38 (95% …

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