Abstract
Objective: The effects of preoperative (pre-op) renin-angiotensin system (RAS) inhibitors on outcomes in patients undergoing cardiac surgery remain uncertain. The aim of this study was to evaluate whether the use of pre-op RAS inhibitors affected major outcomes of cardiac surgery. Design: A retrospective cohort study. Setting: A university teaching hospital. Participants: Patients undergoing cardiac surgery between January 1, 2001 and December 31, 2011. Interventions: One thousand two hundred thirty-nine patients who received pre-op RAS inhibitors were compared with those who did not (control group, n = 1,083). Measurements and Main Results: Acute kidney injury (AKI) was defined using Acute Kidney Injury Network classification. Patients in the RAS inhibitors group presented with higher comorbidities. Pre-op RAS inhibitors therapy was associated with the reduction in the incidence of AKI (27.2% v 34.0%, p<0.001), septicemia (1.9% v 3.5%, p = 0.019), and operative mortality (2.99% v 4.62%, p = 0.039). After adjusted propensity scores and multivariate logistic regression, the pre-op RAS inhibitors were found to have protective effects against AKI (odds ratio [OR]: 0.764, 95% confidence interval [CI]: 0.670-0.873, p<0.001), septicemia (OR: 0.515, 95% CI: 0.348-0.761, p>0.001), and operative mortality (OR: 0.539, 95% CI: 0.348-0.758, p<0.001). Conclusion: The results suggested that pre-op RAS inhibitor therapy was associated with significant reductions in the risk of AKI, operative mortality, and septicemia.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 703-709 |
| Number of pages | 7 |
| Journal | Journal of Cardiothoracic and Vascular Anesthesia |
| Volume | 27 |
| Issue number | 4 |
| DOIs | |
| State | Published - Aug 2013 |
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Keywords
- acute kidney injury
- cardiac surgery
- renin-angiotensin system inhibitors
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Anesthesiology and Pain Medicine
Cite this
The effects of preoperative renin-angiotensin system inhibitors on outcomes in patients undergoing cardiac surgery. / Shi, Pengcai; Li, Zhongmin; Young, J Nilas; Ji, Fuhai; Wang, Yuelan; Moore, Peter G; Liu, Hong.
In: Journal of Cardiothoracic and Vascular Anesthesia, Vol. 27, No. 4, 08.2013, p. 703-709.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The effects of preoperative renin-angiotensin system inhibitors on outcomes in patients undergoing cardiac surgery
AU - Shi, Pengcai
AU - Li, Zhongmin
AU - Young, J Nilas
AU - Ji, Fuhai
AU - Wang, Yuelan
AU - Moore, Peter G
AU - Liu, Hong
PY - 2013/8
Y1 - 2013/8
N2 - Objective: The effects of preoperative (pre-op) renin-angiotensin system (RAS) inhibitors on outcomes in patients undergoing cardiac surgery remain uncertain. The aim of this study was to evaluate whether the use of pre-op RAS inhibitors affected major outcomes of cardiac surgery. Design: A retrospective cohort study. Setting: A university teaching hospital. Participants: Patients undergoing cardiac surgery between January 1, 2001 and December 31, 2011. Interventions: One thousand two hundred thirty-nine patients who received pre-op RAS inhibitors were compared with those who did not (control group, n = 1,083). Measurements and Main Results: Acute kidney injury (AKI) was defined using Acute Kidney Injury Network classification. Patients in the RAS inhibitors group presented with higher comorbidities. Pre-op RAS inhibitors therapy was associated with the reduction in the incidence of AKI (27.2% v 34.0%, p<0.001), septicemia (1.9% v 3.5%, p = 0.019), and operative mortality (2.99% v 4.62%, p = 0.039). After adjusted propensity scores and multivariate logistic regression, the pre-op RAS inhibitors were found to have protective effects against AKI (odds ratio [OR]: 0.764, 95% confidence interval [CI]: 0.670-0.873, p<0.001), septicemia (OR: 0.515, 95% CI: 0.348-0.761, p>0.001), and operative mortality (OR: 0.539, 95% CI: 0.348-0.758, p<0.001). Conclusion: The results suggested that pre-op RAS inhibitor therapy was associated with significant reductions in the risk of AKI, operative mortality, and septicemia.
AB - Objective: The effects of preoperative (pre-op) renin-angiotensin system (RAS) inhibitors on outcomes in patients undergoing cardiac surgery remain uncertain. The aim of this study was to evaluate whether the use of pre-op RAS inhibitors affected major outcomes of cardiac surgery. Design: A retrospective cohort study. Setting: A university teaching hospital. Participants: Patients undergoing cardiac surgery between January 1, 2001 and December 31, 2011. Interventions: One thousand two hundred thirty-nine patients who received pre-op RAS inhibitors were compared with those who did not (control group, n = 1,083). Measurements and Main Results: Acute kidney injury (AKI) was defined using Acute Kidney Injury Network classification. Patients in the RAS inhibitors group presented with higher comorbidities. Pre-op RAS inhibitors therapy was associated with the reduction in the incidence of AKI (27.2% v 34.0%, p<0.001), septicemia (1.9% v 3.5%, p = 0.019), and operative mortality (2.99% v 4.62%, p = 0.039). After adjusted propensity scores and multivariate logistic regression, the pre-op RAS inhibitors were found to have protective effects against AKI (odds ratio [OR]: 0.764, 95% confidence interval [CI]: 0.670-0.873, p<0.001), septicemia (OR: 0.515, 95% CI: 0.348-0.761, p>0.001), and operative mortality (OR: 0.539, 95% CI: 0.348-0.758, p<0.001). Conclusion: The results suggested that pre-op RAS inhibitor therapy was associated with significant reductions in the risk of AKI, operative mortality, and septicemia.
KW - acute kidney injury
KW - cardiac surgery
KW - renin-angiotensin system inhibitors
UR - http://www.scopus.com/inward/record.url?scp=84880320851&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84880320851&partnerID=8YFLogxK
U2 - 10.1053/j.jvca.2013.01.012
DO - 10.1053/j.jvca.2013.01.012
M3 - Article
C2 - 23731712
AN - SCOPUS:84880320851
VL - 27
SP - 703
EP - 709
JO - Journal of Cardiothoracic and Vascular Anesthesia
JF - Journal of Cardiothoracic and Vascular Anesthesia
SN - 1053-0770
IS - 4
ER -