Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Mortality of Coronary Artery Bypass Grafting

  • Ahmad Sharafi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Saeed Davoodi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • AbbasAli Karimi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Hosein Ahmadi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Kyomars Abbasi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Mahmood Sheikh-Fathollahi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Payvand Bina Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Maryam Soleymanzadeh Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Arezoo Fehri Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Saeid Davaran Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Siroos Jahangheeri Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
  • SeyedEbrahim Kassaian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Keywords: Angiotensin-converting enzyme inhibitors • Coronary artery bypass • Outcome assessment (health care) • Hospital mortality

Abstract

Background: 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.Methods: 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.Results: 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 inasmuch 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.Conclusion: Preoperative ACEI usage in patients undergoing CABG can be associated with decreased in-hospital mortality. Large-scale randomized clinical trials are suggested.
Published
2015-10-11
How to Cite
1.
Sharafi A, Davoodi S, Karimi A, Ahmadi H, Abbasi K, Sheikh-Fathollahi M, Bina P, Soleymanzadeh M, Fehri A, Davaran S, Jahangheeri S, Kassaian S. Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Mortality of Coronary Artery Bypass Grafting. J Tehran Heart Cent. 8(4):177-81.
Section
Original Article(s)