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March 30, 2021Reviews in Cardiovascular MedicineOpen Access

Antecedent ACE-inhibition, inflammatory response, and cardiac surgery associated acute kidney injury

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Why the study?

CPB can trigger organ damage, including kidney injury, through cytokine release, but the impact of chronic ACE-I treatment on this inflammatory response and postoperative renal function was unclear.

Does long-term ACE-inhibitor use alter the inflammatory response and affect renal function in patients undergoing major cardiac surgery with cardiopulmonary bypass?

Comparison

Long-term (> 6 mo.) ACE-I use vs no ACE-I use

Design

Observational, prospective study

Follow-up

10 days

Authors

PPPierangela PrestaDBDavide BolignanoGCGiuseppe Coppolino

Discussion

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Overview

Chronic ACE-I use may modulate select post-CPB cytokines without altering AKI incidence or GFR recovery; leaves open any clinical renal benefit in larger trials.

Structured PICO

Does long-term ACE-inhibitor use alter the inflammatory response and affect renal function in patients undergoing major cardiac surgery with cardiopulmonary bypass?

P
Population
69 patients undergoing major cardiac surgery with cardiopulmonary bypass (CPB)
I
Intervention
Long-term (> 6 months) ACE-inhibitor use (n=38)
C
Comparator
No long-term ACE-inhibitor use (n=31)
O
Outcome
Change in IL-1alpha, IL-1beta, IL-2, IL-4, IL-6, IL-8, IL-10, TNF alpha, EGF and VEGF plasma levelssurrogate

Long-term ACE-inhibitor use prior to cardiac surgery with cardiopulmonary bypass alters the postoperative inflammatory response but does not significantly affect perioperative renal outcomes such as acute kidney injury.

Cite This Study

Presta et al. (2021) studied this question.

synapsesocial.com/papers/6a865d5454e3ec4cc25aef66https://doi.org/10.31083/j.rcm.2021.01.288
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