The Effects of Preoperative Renin-Angiotensin System Inhibitors on Outcomes in Patients Undergoing Cardiac Surgery
| Autor: | Fuhai Ji, Zhongmin Li, Yuelan Wang, Pengcai Shi, Hong Liu, J. Nilas Young, Peter G. Moore |
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| Rok vydání: | 2013 |
| Předmět: |
Male
medicine.medical_specialty Critical Care Myocardial Infarction Cohort Studies Renin-Angiotensin System Postoperative Complications Risk Factors Internal medicine Preoperative Care Renin–angiotensin system Humans Medicine In patient Cardiac Surgical Procedures Coronary Artery Bypass Intraoperative Complications Creatine Kinase Aged Retrospective Studies Aged 80 and over Ras Inhibitor business.industry Incidence (epidemiology) Acute kidney injury Retrospective cohort study Acute Kidney Injury Length of Stay Middle Aged medicine.disease Heart Valves Cardiac surgery Stroke Treatment Outcome Anesthesiology and Pain Medicine Anesthesia Female University teaching Cardiology and Cardiovascular Medicine business |
| Zdroj: | Journal of Cardiothoracic and Vascular Anesthesia. 27:703-709 |
| ISSN: | 1053-0770 |
| DOI: | 10.1053/j.jvca.2013.01.012 |
| Popis: | 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.A retrospective cohort study.A university teaching hospital.Patients undergoing cardiac surgery between January 1, 2001 and December 31, 2011.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).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%, p0.001), 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, p0.001), septicemia (OR: 0.515, 95% CI: 0.348-0.761, p0.001), and operative mortality (OR: 0.539, 95% CI: 0.348-0.758, p0.001).The results suggested that pre-op RAS inhibitor therapy was associated with significant reductions in the risk of AKI, operative mortality, and septicemia. |
| Databáze: | OpenAIRE |
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