Key result
ACE inhibitor use is linked to ~45% fewer major adverse events after heart transplantation.
Why the study?
The effect of ACE inhibitors on prognosis and myocardial remodeling in heart transplant recipients was studied to assess potential benefits after heart transplantation.
Cohort (n=386)
Open-label
No
Absolute Event Rate: 10.6% vs 19.2%
p-value: p=0.045
May support ACE inhibitor consideration after heart transplant; leaves open need for randomized confirmation.
Aim.To study the effect of ACE inhibitors (ACEI) in heart recipients on the prognosis and myocardial remodeling. Materials and methods.Three hundred and eighty-six patients who received orthotopic heart transplantation (HT) were consequently enrolled to the study from February 2009 to November 2016. Results.Thirty days after the HT, ACEIs were assigned to 141 recipients. Arterial hypertension was diagnosed in all cardiac recipients who received ACEI and among 48 patients (19.5%) from non-ACEI group. Patients receiving ACEI had significantly better event-free survival than control group (p = 0.045) during the follow-up for 1361,6 ± 36,9 days. Left ventricle (LV) end-diastolic dimension did not change over the time in both groups, whereas LV posterior wall thickness in non-ACEI group significantly increased from 1.35 ± 0.03 cm to 1,23 ± 0.05 cm (p < 0.05). Conclusion.Cardiac recipients who received ACE inhibitors had better survival and less transplant left ventricle progression, that could reflect beneficial effects of renin-aldosterone-angiotensin system inhibition after heart transplantation.
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Шевченко et al. (2019) conducted a cohort in Heart transplantation (n=386). Angiotensin-converting enzyme inhibitors (ACEI) vs. No ACEI was evaluated on Event-free survival (death from all causes and irreversible dysfunction requiring retransplantation) (p=0.045). Heart transplant recipients receiving ACE inhibitors demonstrated significantly better event-free survival compared to those not receiving the therapy (10.6% vs 19.2% adverse events, p=0.045).
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