November 1, 2008Journal of Cardiovascular Medicine
Preoperative angiotensin-converting enzyme inhibitors protect myocardium from ischemia during coronary artery bypass graft surgery
Key result
Preoperative ACE inhibitors in patients undergoing on-pump CABG were associated with a lower postoperative peak cardiac troponin I concentration (1.6 vs 2.4 ng/ml; adjusted P=0.004).
Why the study?
Do preoperative ACE inhibitors reduce perioperative myocardial injury in patients undergoing isolated on-pump coronary artery bypass graft surgery?
Population
481 patients undergoing isolated on-pump coronary artery bypass graft surgery
Comparison
Preoperative angiotensin-converting enzyme… vs No preoperative ACE inhibitors (n=236)
Design
Cohort
Follow-up
Perioperative/postoperative period
Authors
Discussion
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Member takes
Implication
Should not yet change perioperative ACE inhibitor use in on-pump CABG; hypothesis-generating and requires randomized confirmation.
Study Design
Type
Cohort (n=481)
Structured PICO
Do preoperative ACE inhibitors reduce perioperative myocardial injury in patients undergoing isolated on-pump coronary artery bypass graft surgery?
P
Population
481 patients undergoing isolated on-pump coronary artery bypass graft surgery.
E
Exposure
Preoperative angiotensin-converting enzyme (ACE) inhibitors (n=245)
C
Comparator
No preoperative ACE inhibitors (n=236)
O
Outcome
Perioperative myocardial injury assessed by postoperative peak concentration of cardiac troponin I (cTnI)surrogate
Main Result
Effect estimate: beta = -0.12
Absolute Event Rate: 1.6% vs 2.4%
p-value: p=0.004
Preoperative ACE inhibitor therapy is associated with reduced perioperative myocardial injury, as measured by peak cTnI levels, in patients undergoing on-pump CABG.
Cite This Study
Benedetto et al. (2008) conducted a cohort in Coronary artery bypass graft surgery (n=481). Preoperative ACE inhibitors vs. No preoperative ACE inhibitors was evaluated on Postoperative cTnI peak concentration (beta = -0.12, p=0.004). Preoperative ACE inhibitors in patients undergoing on-pump CABG were associated with a lower postoperative peak cardiac troponin I concentration (1.6 vs 2.4 ng/ml; adjusted P=0.004).