Abstract 17433: Improved Outcomes in Septic Shock With Pre-hospitalization Use of Angiotensin-converting Enzyme Inhibitors (ACEI) and Angiotensin Receptor Blockers (ARB)

Autor:	Sagger Mawri, Jainil Shah, Jain Tarun, Rami Dirani, Alexander Michaels, Joseph Gibbs, Daryl Sudasena, Yasser Alsafadi, Ruchira Sengupta, Derar Albashaireh, Karthik Ananthasubramaniam
Rok vydání:	2015
Předmět:	Physiology (medical) cardiovascular diseases urologic and male genital diseases Cardiology and Cardiovascular Medicine
Zdroj:	Circulation. 132
ISSN:	1524-4539 0009-7322
DOI:	10.1161/circ.132.suppl_3.17433
Popis:	Background: The neurohormonal effects of angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are well recognized. Recent molecular studies have also demonstrated novel immune-modulating properties of ACEI/ARB through reduction of pro-inflammatory cytokines. In a recent study, obese trauma patients on pre-injury ACEI/ARB had reduced multi-organ failure scores and improved T cell function and monocyte maturation as compared to those not on ACEI/ARB. We sought to determine whether pre-hospital use of ACEI/ARB conferred improvements in outcomes in patients with septic shock (SS). Methods: We evaluated 248 patients admitted to the ICU with SS from January 2011 to April 2013. Comprehensive baseline demographic, clinical and echocardiographic data was obtained at time of ICU admission. We identified 90 patients on ACEI/ARB prior to ICU admission. Chi-square and t-tests were used to assess for differences in clinical parameters and outcomes in patients who were on ACE/ARB prior to ICU admission (ACE/ARB group) versus those not on ACEI/ARB prior to ICU admission (non-ACEI/ARB group). Results: Patients in the ACE/ARB group (36%) had significantly lower heart rate (95.8 bpm vs 102.3 bpm, p Conclusion: ACEI/ARB use prior to ICU admission is associated with improved outcomes in SS patients, not explained by laboratory or echocardiographic differences. This provides further support for the possible immunomodulating benefits of ACEI/ARBs; however, more studies are needed to confirm these findings.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::2db0fb4ed3a31ed62fae1c915709dd2e https://doi.org/10.1161/circ.132.suppl_3.17433 Zobrazit plný text záznamu