Key result
Preoperative use of ACEIs before CABG surgery significantly increased the risk of hypotension (RR 2.36; 95% CI 1.11-5.02; P=0.03), postoperative myocardial infarction, and renal dysfunction.
Why the study?
Does preoperative administration of ACEIs affect clinical outcomes and safety in patients undergoing CABG surgery?
Population
31,390 patients undergoing isolated coronary artery bypass grafting surgery
Comparison
Preoperative administration of… vs Placebo
Design
Meta-analysis
Follow-up
early postoperative period
Authors
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Preoperative ACEI use may increase postoperative MI risk in CABG; challenges routine continuation and leaves open need for RCTs.
Systematic Review (n=31,390)
Does preoperative administration of ACEIs affect clinical outcomes and safety in patients undergoing CABG surgery?
Relative Risk: 2.36 (95% CI 1.11–5.02)
p-value: p=0.03
Preoperative administration of ACE inhibitors before CABG surgery increases the risk of postoperative hypotension, myocardial infarction, and renal dysfunction without improving early mortality.
Zhang et al. (2014) conducted a systematic review in Coronary artery bypass grafting (CABG) surgery (n=31,390). Preoperative angiotensin-converting enzyme inhibitors (ACEIs) vs. Placebo was evaluated on Hypotension (RR 2.36, 95% CI 1.11-5.02, p=0.03). Preoperative use of ACEIs before CABG surgery significantly increased the risk of hypotension (RR 2.36; 95% CI 1.11-5.02; P=0.03), postoperative myocardial infarction, and renal dysfunction.
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