Key result
Preoperative use of ACEI or ARB was associated with an increased incidence of postoperative atrial fibrillation after off-pump coronary artery bypass graft surgery (OR 1.66; 95% CI 1.04-2.62; P=0.03).
Why the study?
Does preoperative treatment with an ACEI or ARB prevent new-onset postoperative atrial fibrillation in patients undergoing off-pump coronary artery bypass graft surgery?
Cohort (n=1,050)
Does preoperative treatment with an ACEI or ARB prevent new-onset postoperative atrial fibrillation in patients undergoing off-pump coronary artery bypass graft surgery?
Odds Ratio: 1.66 (95% CI 1.04–2.62)
p-value: p=0.03
Preoperative use of ACEI or ARB does not prevent, and may paradoxically increase the risk of, new-onset postoperative atrial fibrillation in patients undergoing off-pump CABG.
Does not support preoperative ACEI/ARB for POAF prevention in off-pump CABG; leaves open whether association reflects confounding.
BACKGROUND: The present study investigated whether preoperative angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) use affected the incidence of postoperative atrial fibrillation (POAF) in patients undergoing off-pump coronary artery bypass graft (OPCAB). HYPOTHESIS: Preoperative use of ACEI or ARB was related to POAF in patients undergoing OPCAB. METHODS: This retrospective, observational, cohort study involved 1050 patients who underwent OPCAB from January 2006 to December 2009. RESULTS: ACEI or ARB, ACEI alone, and ARB alone did not exert beneficial effect on the occurrence of POAF, and ACEI or ARB use was rather associated with an increased incidence of POAF (ACEI or ARB: odds ratio [OR]: 1.66, 95% confidence interval [CI]: 1.04-2.62, P = 0.03; ACEI alone: OR: 1.30, 95% CI: 0.57-2.97, P = 0.53; ARB alone: OR: 1.57, 95% CI: 0.93-2.64, P = 0.09). CONCLUSIONS: ACEI or ARB, ACEI alone, and ARB alone did not favorably influence the occurrence of POAF in patients undergoing OPCAB.
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Chin et al. (2011) conducted a cohort in Off-pump coronary artery bypass graft (OPCAB) (n=1,050). Preoperative ACEI or ARB was evaluated on Postoperative atrial fibrillation (POAF) (OR 1.66, 95% CI 1.04-2.62, p=0.03). Preoperative use of ACEI or ARB was associated with an increased incidence of postoperative atrial fibrillation after off-pump coronary artery bypass graft surgery (OR 1.66; 95% CI 1.04-2.62; P=0.03).
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