MedicalResearch.com Interview with: Matthew D. Krasowski MD, PhD Department of Pathology University of Iowa, Iowa City, and Jonathan Genzen, MD, PhD Department of Pathology University of Utah, Salt Lake City, UT Medical Research: What is the background for this study? What are the main findings? Response: Serum angiotensin converting enzyme (ACE) activity is commonly measured for the diagnosis and management of sarcoidosis. It was well known several decades ago that serum ACE activity is reduced in patients taking ACE inhibitors (e.g., captopril, enalapril, lisinopril, etc.). However, providers ordering ACE levels may be unaware of this interaction and not realize that ACE inhibitor therapy can dramatically lower serum ACE activity (and thus resulting in a misleadingly low ACE level). The main goal of the study was to determine how often serum ACE levels were performed in patients prescribed ACE inhibitors. Using electronic medical record review at an academic medical center, it was determined that 8.4% of serum ACE levels were ordered on patients currently on ACE inhibitors. The group of patients on ACE inhibitors had significantly lower serum ACE activity than the other patients. Analysis of samples at a national reference laboratory arrived at a similar estimate. This analysis included detection of lisinopril in a subset of serum samples with very low ACE activity. At the academic medical center, the use of targeted warning prompts and alerts greatly reduced the frequency of ordering serum ACE activity in patients on ACE inhibitors. (more…)