Perioperative use of renin-angiotensin system inhibitors and outcomes in patients undergoing cardiac surgery

Qian Ding, Zugui Zhang, Hong Liu, Huang Nie, Mark Berguson, Jordan E. Goldhammer, Nilas Young, Douglas Boyd, Rohinton Morris and Jianzhong Sun ()
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Qian Ding: Thomas Jefferson University
Zugui Zhang: Christiana Care Health System
Hong Liu: University of California Davis Medical Center
Huang Nie: Thomas Jefferson University
Mark Berguson: Thomas Jefferson University
Jordan E. Goldhammer: Thomas Jefferson University
Nilas Young: University of California Davis Medical Center
Douglas Boyd: University of California Davis Medical Center
Rohinton Morris: Thomas Jefferson University
Jianzhong Sun: Thomas Jefferson University

Nature Communications, 2019, vol. 10, issue 1, 1-10

Abstract: Abstract It remains disputable about perioperative use of renin-angiotensin system inhibitors (RASi) and their outcome effects. This multicenter retrospective cohort study examines association between use of perioperative RASi and outcomes in patients undergoing coronary artery bypass graft and/or valve surgery. After the exclusion, the patients are divided into 2 groups with or without preoperative RASi (PreRASi, n = 8581), or 2 groups with or without postoperative RASi (PostRASi, n = 8130). With using of propensity scores matching to reduce treatment selection bias, the study shows that PreRASi is associated with a significant reduction in postoperative 30-day mortality compared with without one (3.41% vs. 5.02%); PostRASi is associated with reduced long-term mortality rate compared with without one (6.62% vs. 7.70% at 2-year; 17.09% vs. 19.95% at 6-year). The results suggest that perioperative use of RASi has a significant benefit for the postoperative and long-term survival among patients undergoing cardiac surgery.

Date: 2019
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DOI: 10.1038/s41467-019-11678-9

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