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

Author:
Ding, Qian  Zhang, Zugui  Liu, Hong  Nie, Huang  Berguson, Mark  Goldhammer, Jordan E.  Young, Nilas  Boyd, Douglas  Morris, Rohinton  Sun, Jianzhong  


Journal:
NATURE COMMUNICATIONS


Issue Date:
2019


Abstract(summary):

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 =3D 8581), or 2 groups with or without postoperative RASi (PostRASi, n =3D 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.


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