Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Mortality of Coronary Artery Bypass Grafting
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 betwee...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Tehran University of Medical Sciences
2015-10-01
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| Series: | Journal of Tehran University Heart Center |
| Subjects: | |
| Online Access: | https://jthc.tums.ac.ir/index.php/jthc/article/view/306 |
| _version_ | 1811264290029568000 |
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| author | Ahmad Sharafi Saeed Davoodi AbbasAli Karimi Hosein Ahmadi Kyomars Abbasi Mahmood Sheikh-Fathollahi Payvand Bina Maryam Soleymanzadeh Arezoo Fehri Saeid Davaran Siroos Jahangheeri SeyedEbrahim Kassaian |
| author_facet | Ahmad Sharafi Saeed Davoodi AbbasAli Karimi Hosein Ahmadi Kyomars Abbasi Mahmood Sheikh-Fathollahi Payvand Bina Maryam Soleymanzadeh Arezoo Fehri Saeid Davaran Siroos Jahangheeri SeyedEbrahim Kassaian |
| author_sort | Ahmad Sharafi |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-12T20:00:27Z |
| format | Article |
| id | doaj.art-c1787f0c8e174af08f4ce4194987f201 |
| institution | Directory Open Access Journal |
| issn | 1735-8620 2008-2371 |
| language | English |
| last_indexed | 2024-04-12T20:00:27Z |
| publishDate | 2015-10-01 |
| publisher | Tehran University of Medical Sciences |
| record_format | Article |
| series | Journal of Tehran University Heart Center |
| spelling | doaj.art-c1787f0c8e174af08f4ce4194987f2012022-12-22T03:18:32ZengTehran University of Medical SciencesJournal of Tehran University Heart Center1735-86202008-23712015-10-0184302Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Mortality of Coronary Artery Bypass GraftingAhmad Sharafi0Saeed Davoodi1AbbasAli Karimi2Hosein Ahmadi3Kyomars Abbasi4Mahmood Sheikh-Fathollahi5Payvand Bina6Maryam Soleymanzadeh7Arezoo Fehri8Saeid Davaran9Siroos Jahangheeri10SeyedEbrahim Kassaian11Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.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.https://jthc.tums.ac.ir/index.php/jthc/article/view/306Angiotensin-converting enzyme inhibitors • Coronary artery bypass • Outcome assessment (health care) • Hospital mortality |
| spellingShingle | Ahmad Sharafi Saeed Davoodi AbbasAli Karimi Hosein Ahmadi Kyomars Abbasi Mahmood Sheikh-Fathollahi Payvand Bina Maryam Soleymanzadeh Arezoo Fehri Saeid Davaran Siroos Jahangheeri SeyedEbrahim Kassaian Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Mortality of Coronary Artery Bypass Grafting Journal of Tehran University Heart Center Angiotensin-converting enzyme inhibitors • Coronary artery bypass • Outcome assessment (health care) • Hospital mortality |
| title | Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Mortality of Coronary Artery Bypass Grafting |
| title_full | Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Mortality of Coronary Artery Bypass Grafting |
| title_fullStr | Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Mortality of Coronary Artery Bypass Grafting |
| title_full_unstemmed | Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Mortality of Coronary Artery Bypass Grafting |
| title_short | Impact of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers on Mortality of Coronary Artery Bypass Grafting |
| title_sort | impact of angiotensin converting enzyme inhibitors and angiotensin receptor blockers on mortality of coronary artery bypass grafting |
| topic | Angiotensin-converting enzyme inhibitors • Coronary artery bypass • Outcome assessment (health care) • Hospital mortality |
| url | https://jthc.tums.ac.ir/index.php/jthc/article/view/306 |
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