Key result
Captopril administration before off-pump coronary artery bypass graft surgery significantly reduced mean systolic blood pressure during the procedure (93.1 vs 110.0 mmHg, p<0.001) and increased the incidence of hypotension (70% vs 30%).
Why the study?
Does preoperative captopril affect hemodynamic responses and vasoactive drug requirements before, during, and after off-pump CABG surgery?
RCT (n=54)
Randomly allocated
No
Does preoperative captopril affect hemodynamic responses and vasoactive drug requirements before, during, and after off-pump CABG surgery?
Absolute Event Rate: 93.1% vs 110%
p-value: p=<0.001
Preoperative use of captopril before off-pump CABG effectively reduces blood pressure but significantly increases the incidence of intraoperative hypotension and the requirement for dobutamine.
Advises caution with preoperative captopril before off-pump CABG due to higher hypotension rates; extends RCT evidence on ACEI hemodynamic effects.
Background: According to the previous studies, antihypertensive drugs should be withdrawn before surgery. Nowadays it is accepted that some drugs effectively control systemic blood pressure (BP) to assure its desirable therapeutic control. Objectives: In this study, the effects of captopril, an angiotensin converting enzyme inhibitor (ACEI), on hemodynamic changes before, during and after the coronary artery bypass graft (CABG) surgery was studied. Patients and Methods: In this study, 54 patients were randomly selected in the cardiac surgery ward of Ahvaz Golestan Hospital. Amongst them, 27 patients (control group) did not consume any ACEI for controlling BP but the remained 27 patients (experimental group) used the drugs. In these groups, the effects of captopril on hemodynamic changes before, during and after surgery were studies. Results: Two groups did not have any significant differences in oxygen saturation (P value: before, 0.15; during, 0.08; and after CABG, 0.53) and pulse rate (P value: before, 0.09; during, 0.25; and after CABG, 0.15). Nevertheless, they had significant differences in changes in systolic and diastolic BP in different time points (P Value of systolic BP: before, 0.001; during, < 0.001; and after CABG, 0.007; and P Value of diastolic BP: before, < 0.001; during, 0.001; and after CABG, 0.009). Conclusions: Using ACEI can effectively reduce the systolic and diastolic BP before, during, and after CABG surgery without any effects on oxygen saturation and pulse rate.
No takes yet. Share an insight, caveat, or question.
Ebadi et al. (2014) conducted an RCT in Ischemic heart disease and hypertension requiring CABG (n=54). Captopril vs. Metoral 25 mg four times a day was evaluated on Mean systolic blood pressure during CABG (mmHg) (p=<0.001). Captopril administration before off-pump coronary artery bypass graft surgery significantly reduced mean systolic blood pressure during the procedure (93.1 vs 110.0 mmHg, p<0.001) and increased the incidence of hypotension (70% vs 30%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: