Impact of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers on mortality of coronary artery bypass grafting
Journal of Tehran University Heart Center [The]. 2013; 8 (4): 177-181
em Inglês
| IMEMR
| ID: emr-147897
ABSTRACT
There is controversy over the potential benefits/harms of the usage of angiotensin-converting enzyme inhibitors [ACEIs] or angiotensin receptor blockers [ARBs] as regards the postoperative mortality of coronary artery bypass grafting [CABG]. This study investigates the correlation between the in-hospital mortality of CABG and the preoperative administration of ACEI/ARB. Out of 10055 consecutive patients with isolated CABG from 2006 to 2009, 4664 [46.38%] patients received preoperative ACEI/ARB. Data were gathered from the Cardiac Surgery Registry of Tehran Heart Center. In-hospital mortality was defined as death within the same admission for surgery. Adjusted for confounders, multivariable logistic regression models were used to evaluate the impact of preoperative ACEI/ARB therapy on in-hospital death. The mean age of the patients was 60.04 +/- 9.51 years and 7364 [73.23%] were male. Eighty-seven [0.86%] patients expired within 30 days. Multivariate analysis revealed that the administration of ACEI/ARB significantly protected against in-hospital deaths in as much as there were 33 [0.70%] vs. 54 [1.0%] deaths in the ACEI/ARB positive and negative groups, respectively [OR 0.628; p value = 0.09]. Patients without ACEI/ARB were more likely to have a higher global ejection fraction. Preoperative ACEI usage in patients undergoing CABG can be associated with decreased in-hospital mortality. Large-scale randomized clinical trials are suggested
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Índice:
IMEMR (Mediterrâneo Oriental)
Tipo de estudo:
Ensaio Clínico Controlado
Idioma:
Inglês
Revista:
J. Tehran Univ. Heart Cent.
Ano de publicação:
2013
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