ACE inhibitors in cardiac surgery: Current studies and controversies

Jian Zhong Sun, Long Hui Cao, Hong Liu

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Major complications associated with cardiac surgery are still common and carry great prognostic significance. Current medical interventions to prevent these cardiovascular complications include antiplatelet therapy, statins, Β-blockers and angiotensin-converting enzyme (ACE) inhibitors. Both experimental studies and clinical trials have shown that ACE inhibitors hold promise as cardiovascular protective agents for cardiac surgery patients. Several lines of evidence support this hypothesis. First, long-term use of ACE inhibitors has been well established to provide cardiovascular protection and reduce ischemic events and complications, independent of their effect on heart function and blood pressure. Second, early ACE inhibitor therapy has been demonstrated to produce remarkable survival and heart function benefits in patients with acute myocardial infarction. Third, ACE blockage can prevent or delay the development or progression of renal disease at all stages, from subclinical microalbuminuria to end-stage renal disease. Nevertheless, perioperative studies of the effects of ACE inhibitors remain few and inconclusive. Results from recent clinical trials and observational studies are conflicting and raise more questions than answers. Further studies, both retrospective and larger-scale prospective studies, are critically needed to examine whether ACE inhibitors reduce mortality and major complications in patients undergoing cardiac surgery.

Original languageEnglish (US)
Pages (from-to)15-22
Number of pages8
JournalHypertension Research
Volume34
Issue number1
DOIs
StatePublished - Jan 2011

Fingerprint

Angiotensin-Converting Enzyme Inhibitors
Thoracic Surgery
Clinical Trials
Enzyme Therapy
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Protective Agents
Cardiovascular Agents
Peptidyl-Dipeptidase A
Chronic Kidney Failure
Observational Studies
Disease Progression
Retrospective Studies
Myocardial Infarction
Prospective Studies
Blood Pressure
Kidney
Survival
Mortality

Keywords

  • ACE inhibitors
  • cardiac surgery
  • cardiovascular disease

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

ACE inhibitors in cardiac surgery : Current studies and controversies. / Sun, Jian Zhong; Cao, Long Hui; Liu, Hong.

In: Hypertension Research, Vol. 34, No. 1, 01.2011, p. 15-22.

Research output: Contribution to journalArticle

Sun, Jian Zhong ; Cao, Long Hui ; Liu, Hong. / ACE inhibitors in cardiac surgery : Current studies and controversies. In: Hypertension Research. 2011 ; Vol. 34, No. 1. pp. 15-22.
@article{1bce43c02e484536a4ab581561063b16,
title = "ACE inhibitors in cardiac surgery: Current studies and controversies",
abstract = "Major complications associated with cardiac surgery are still common and carry great prognostic significance. Current medical interventions to prevent these cardiovascular complications include antiplatelet therapy, statins, Β-blockers and angiotensin-converting enzyme (ACE) inhibitors. Both experimental studies and clinical trials have shown that ACE inhibitors hold promise as cardiovascular protective agents for cardiac surgery patients. Several lines of evidence support this hypothesis. First, long-term use of ACE inhibitors has been well established to provide cardiovascular protection and reduce ischemic events and complications, independent of their effect on heart function and blood pressure. Second, early ACE inhibitor therapy has been demonstrated to produce remarkable survival and heart function benefits in patients with acute myocardial infarction. Third, ACE blockage can prevent or delay the development or progression of renal disease at all stages, from subclinical microalbuminuria to end-stage renal disease. Nevertheless, perioperative studies of the effects of ACE inhibitors remain few and inconclusive. Results from recent clinical trials and observational studies are conflicting and raise more questions than answers. Further studies, both retrospective and larger-scale prospective studies, are critically needed to examine whether ACE inhibitors reduce mortality and major complications in patients undergoing cardiac surgery.",
keywords = "ACE inhibitors, cardiac surgery, cardiovascular disease",
author = "Sun, {Jian Zhong} and Cao, {Long Hui} and Hong Liu",
year = "2011",
month = "1",
doi = "10.1038/hr.2010.188",
language = "English (US)",
volume = "34",
pages = "15--22",
journal = "Hypertension Research",
issn = "0916-9636",
publisher = "Nature Publishing Group",
number = "1",

}

TY - JOUR

T1 - ACE inhibitors in cardiac surgery

T2 - Current studies and controversies

AU - Sun, Jian Zhong

AU - Cao, Long Hui

AU - Liu, Hong

PY - 2011/1

Y1 - 2011/1

N2 - Major complications associated with cardiac surgery are still common and carry great prognostic significance. Current medical interventions to prevent these cardiovascular complications include antiplatelet therapy, statins, Β-blockers and angiotensin-converting enzyme (ACE) inhibitors. Both experimental studies and clinical trials have shown that ACE inhibitors hold promise as cardiovascular protective agents for cardiac surgery patients. Several lines of evidence support this hypothesis. First, long-term use of ACE inhibitors has been well established to provide cardiovascular protection and reduce ischemic events and complications, independent of their effect on heart function and blood pressure. Second, early ACE inhibitor therapy has been demonstrated to produce remarkable survival and heart function benefits in patients with acute myocardial infarction. Third, ACE blockage can prevent or delay the development or progression of renal disease at all stages, from subclinical microalbuminuria to end-stage renal disease. Nevertheless, perioperative studies of the effects of ACE inhibitors remain few and inconclusive. Results from recent clinical trials and observational studies are conflicting and raise more questions than answers. Further studies, both retrospective and larger-scale prospective studies, are critically needed to examine whether ACE inhibitors reduce mortality and major complications in patients undergoing cardiac surgery.

AB - Major complications associated with cardiac surgery are still common and carry great prognostic significance. Current medical interventions to prevent these cardiovascular complications include antiplatelet therapy, statins, Β-blockers and angiotensin-converting enzyme (ACE) inhibitors. Both experimental studies and clinical trials have shown that ACE inhibitors hold promise as cardiovascular protective agents for cardiac surgery patients. Several lines of evidence support this hypothesis. First, long-term use of ACE inhibitors has been well established to provide cardiovascular protection and reduce ischemic events and complications, independent of their effect on heart function and blood pressure. Second, early ACE inhibitor therapy has been demonstrated to produce remarkable survival and heart function benefits in patients with acute myocardial infarction. Third, ACE blockage can prevent or delay the development or progression of renal disease at all stages, from subclinical microalbuminuria to end-stage renal disease. Nevertheless, perioperative studies of the effects of ACE inhibitors remain few and inconclusive. Results from recent clinical trials and observational studies are conflicting and raise more questions than answers. Further studies, both retrospective and larger-scale prospective studies, are critically needed to examine whether ACE inhibitors reduce mortality and major complications in patients undergoing cardiac surgery.

KW - ACE inhibitors

KW - cardiac surgery

KW - cardiovascular disease

UR - http://www.scopus.com/inward/record.url?scp=78650876364&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78650876364&partnerID=8YFLogxK

U2 - 10.1038/hr.2010.188

DO - 10.1038/hr.2010.188

M3 - Article

C2 - 20944641

AN - SCOPUS:78650876364

VL - 34

SP - 15

EP - 22

JO - Hypertension Research

JF - Hypertension Research

SN - 0916-9636

IS - 1

ER -