Preoperative treatment with an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker has no beneficial effect on the development of new-onset atrial fibrillation after off-pump coronary artery bypass graft surgery

Clin Cardiol. 2012 Jan;35(1):37-42. doi: 10.1002/clc.20991. Epub 2011 Oct 21.

Abstract

Background: The present study investigated whether preoperative angiotensin-converting enzyme inhibitor (ACEI) or angiotensin receptor blocker (ARB) use affected the incidence of postoperative atrial fibrillation (POAF) in patients undergoing off-pump coronary artery bypass graft (OPCAB).

Hypothesis: Preoperative use of ACEI or ARB was related to POAF in patients undergoing OPCAB.

Methods: This retrospective, observational, cohort study involved 1050 patients who underwent OPCAB from January 2006 to December 2009.

Results: ACEI or ARB, ACEI alone, and ARB alone did not exert beneficial effect on the occurrence of POAF, and ACEI or ARB use was rather associated with an increased incidence of POAF (ACEI or ARB: odds ratio [OR]: 1.66, 95% confidence interval [CI]: 1.04-2.62, P = 0.03; ACEI alone: OR: 1.30, 95% CI: 0.57-2.97, P = 0.53; ARB alone: OR: 1.57, 95% CI: 0.93-2.64, P = 0.09).

Conclusions: ACEI or ARB, ACEI alone, and ARB alone did not favorably influence the occurrence of POAF in patients undergoing OPCAB.

MeSH terms

  • Aged
  • Angiotensin Receptor Antagonists / therapeutic use*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Atrial Fibrillation / epidemiology
  • Atrial Fibrillation / etiology
  • Atrial Fibrillation / prevention & control*
  • Cohort Studies
  • Coronary Artery Bypass, Off-Pump*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Postoperative Complications / prevention & control*
  • Preoperative Care
  • Retrospective Studies

Substances

  • Angiotensin Receptor Antagonists
  • Angiotensin-Converting Enzyme Inhibitors