View source for Coronary artery bypass surgery use of ACE Inhibitors/ARBs

__NOTOC__
{{Coronary artery bypass surgery}}
{{CMG}}; {{AOEIC}} {{VK}}

==2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery (DO NOT EDIT)<ref name="pmid22064599">{{cite journal| author=Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG et al.| title=2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=Circulation | year= 2011 | volume=  | issue=  | pages=  | pmid=22064599 | doi=10.1161/CIR.0b013e31823c074e | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22064599  }} </ref>==
===Angiotensin-Converting Enzyme Inhibitors and Angiotensin-Receptor Blockers (DO NOT EDIT)<ref name="pmid22064599">{{cite journal| author=Hillis LD, Smith PK, Anderson JL, Bittl JA, Bridges CR, Byrne JG et al.| title=2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. | journal=Circulation | year= 2011 | volume=  | issue=  | pages=  | pmid=22064599 | doi=10.1161/CIR.0b013e31823c074e | pmc= |url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22064599  }} </ref>===
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' [[ACE inhibitors|Angiotensin-converting enzyme (ACE) inhibitors]] and [[ARBs|angiotensin-receptor blockers]] given before CABG should be reinstituted postoperatively once the patient is stable, unless contraindicated.<ref name="pmid17307447">{{cite journal |author=Goyal A, Alexander JH, Hafley GE, Graham SH, Mehta RH, Mack MJ, Wolf RK, Cohn LH, Kouchoukos NT, Harrington RA, Gennevois D, Gibson CM, Califf RM, Ferguson TB, Peterson ED |title=Outcomes associated with the use of secondary prevention medications after coronary artery bypass graft surgery |journal=[[The Annals of Thoracic Surgery]] |volume=83 |issue=3 |pages=993–1001 |year=2007 |month=March |pmid=17307447 |doi=10.1016/j.athoracsur.2006.10.046 |url=http://linkinghub.elsevier.com/retrieve/pii/S0003-4975(06)02075-3 |accessdate=2011-12-15}}</ref><ref name="pmid22052934">{{cite journal |author=Smith SC, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, Gibbons RJ, Grundy SM, Hiratzka LF, Jones DW, Lloyd-Jones DM, Minissian M, Mosca L, Peterson ED, Sacco RL, Spertus J, Stein JH, Taubert KA |title=AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update: A Guideline From the American Heart Association and American College of Cardiology Foundation |journal=[[Circulation]] |volume=124 |issue=22 |pages=2458–73 |year=2011 |month=November |pmid=22052934 |doi=10.1161/CIR.0b013e318235eb4d |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=22052934 |accessdate=2011-12-15}}</ref><ref name="pmid11230836">{{cite journal |author=Oosterga M, Voors AA, Pinto YM, Buikema H, Grandjean JG, Kingma JH, Crijns HJ, van Gilst WH |title=Effects of quinapril on clinical outcome after coronary artery bypass grafting (The QUO VADIS Study). QUinapril on Vascular Ace and Determinants of Ischemia |journal=[[The American Journal of Cardiology]] |volume=87 |issue=5 |pages=542–6 |year=2001 |month=March |pmid=11230836 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002914900014284 |accessdate=2011-12-15}}</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' [[ACE inhibitors]] or [[ARBs|angiotensin-receptor blockers]] should be initiated postoperatively and continued indefinitely in CABG patients who were not receiving them preoperatively, who are stable, and who have an [[LVEF]] less than or equal to 40%, [[hypertension]], [[diabetes mellitus]], or [[CKD|chronic kidney disease]], unless contraindicated.<ref name="pmid17307447">{{cite journal |author=Goyal A, Alexander JH, Hafley GE, Graham SH, Mehta RH, Mack MJ, Wolf RK, Cohn LH, Kouchoukos NT, Harrington RA, Gennevois D, Gibson CM, Califf RM, Ferguson TB, Peterson ED |title=Outcomes associated with the use of secondary prevention medications after coronary artery bypass graft surgery |journal=[[The Annals of Thoracic Surgery]] |volume=83 |issue=3 |pages=993–1001 |year=2007 |month=March |pmid=17307447 |doi=10.1016/j.athoracsur.2006.10.046 |url=http://linkinghub.elsevier.com/retrieve/pii/S0003-4975(06)02075-3 |accessdate=2011-12-15}}</ref><ref name="pmid11230836">{{cite journal |author=Oosterga M, Voors AA, Pinto YM, Buikema H, Grandjean JG, Kingma JH, Crijns HJ, van Gilst WH |title=Effects of quinapril on clinical outcome after coronary artery bypass grafting (The QUO VADIS Study). QUinapril on Vascular Ace and Determinants of Ischemia |journal=[[The American Journal of Cardiology]] |volume=87 |issue=5 |pages=542–6 |year=2001 |month=March |pmid=11230836 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002914900014284 |accessdate=2011-12-15}}</ref><ref name="pmid7654275">{{cite journal |author=Garg R, Yusuf S |title=Overview of randomized trials of angiotensin-converting enzyme inhibitors on mortality and morbidity in patients with heart failure. Collaborative Group on ACE Inhibitor Trials |journal=[[JAMA : the Journal of the American Medical Association]] |volume=273 |issue=18 |pages=1450–6 |year=1995 |month=May |pmid=7654275 |doi= |url= |accessdate=2011-12-15}}</ref><ref name="pmid10639539">{{cite journal |author=Yusuf S, Sleight P, Pogue J, Bosch J, Davies R, Dagenais G |title=Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. The Heart Outcomes Prevention Evaluation Study Investigators |journal=[[The New England Journal of Medicine]] |volume=342 |issue=3 |pages=145–53 |year=2000 |month=January |pmid=10639539 |doi=10.1056/NEJM200001203420301 |url=http://dx.doi.org/10.1056/NEJM200001203420301 |accessdate=2011-12-15}}</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: A]])''<nowiki>"</nowiki>
|}

{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' It is reasonable to initiate [[ACE inhibitors]] or [[ARBs|angiotensin-receptor blockers]] postoperatively and to continue them indefinitely in all CABG patients who were not receiving them preoperatively and are considered to be at low risk (ie, those with a normal [[LVEF]] in whom cardiovascular risk factors are well controlled), unless contraindicated.<ref name="pmid17307447">{{cite journal |author=Goyal A, Alexander JH, Hafley GE, Graham SH, Mehta RH, Mack MJ, Wolf RK, Cohn LH, Kouchoukos NT, Harrington RA, Gennevois D, Gibson CM, Califf RM, Ferguson TB, Peterson ED |title=Outcomes associated with the use of secondary prevention medications after coronary artery bypass graft surgery |journal=[[The Annals of Thoracic Surgery]] |volume=83 |issue=3 |pages=993–1001 |year=2007 |month=March |pmid=17307447 |doi=10.1016/j.athoracsur.2006.10.046 |url=http://linkinghub.elsevier.com/retrieve/pii/S0003-4975(06)02075-3 |accessdate=2011-12-15}}</ref><ref name="pmid11230836">{{cite journal |author=Oosterga M, Voors AA, Pinto YM, Buikema H, Grandjean JG, Kingma JH, Crijns HJ, van Gilst WH |title=Effects of quinapril on clinical outcome after coronary artery bypass grafting (The QUO VADIS Study). QUinapril on Vascular Ace and Determinants of Ischemia |journal=[[The American Journal of Cardiology]] |volume=87 |issue=5 |pages=542–6 |year=2001 |month=March |pmid=11230836 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0002914900014284 |accessdate=2011-12-15}}</ref><ref name="pmid17383303">{{cite journal |author=Fox KM, Bertrand ME, Remme WJ, Ferrari R, Simoons ML, Deckers JW |title=Efficacy of perindopril in reducing risk of cardiac events in patients with revascularized coronary artery disease |journal=[[American Heart Journal]] |volume=153 |issue=4 |pages=629–35 |year=2007 |month=April |pmid=17383303 |doi=10.1016/j.ahj.2007.01.032 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-8703(07)00091-9 |accessdate=2011-12-15}}</ref><ref name="pmid10732883">{{cite journal |author=Kjøller-Hansen L, Steffensen R, Grande P |title=The Angiotensin-converting Enzyme Inhibition Post Revascularization Study (APRES) |journal=[[Journal of the American College of Cardiology]] |volume=35 |issue=4 |pages=881–8 |year=2000 |month=March |pmid=10732883 |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(99)00634-8 |accessdate=2011-12-15}}</ref><ref name="pmid18071079">{{cite journal |author=Rouleau JL, Warnica WJ, Baillot R, Block PJ, Chocron S, Johnstone D, Myers MG, Calciu CD, Dalle-Ave S, Martineau P, Mormont C, van Gilst WH |title=Effects of angiotensin-converting enzyme inhibition in low-risk patients early after coronary artery bypass surgery |journal=[[Circulation]] |volume=117 |issue=1 |pages=24–31 |year=2008 |month=January |pmid=18071079 |doi=10.1161/CIRCULATIONAHA.106.685073 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18071079 |accessdate=2011-12-15}}</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}

{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]]
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' The safety of the preoperative administration of [[ACE inhibitors]] or [[ARBs|angiotensin-receptor blockers]] in patients on chronic therapy is uncertain.<ref name="pmid18667735">{{cite journal |author=Arora P, Rajagopalam S, Ranjan R, Kolli H, Singh M, Venuto R, Lohr J |title=Preoperative use of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers is associated with increased risk for acute kidney injury after cardiovascular surgery |journal=[[Clinical Journal of the American Society of Nephrology : CJASN]] |volume=3 |issue=5 |pages=1266–73 |year=2008 |month=September |pmid=18667735 |pmc=2518804 |doi=10.2215/CJN.05271107 |url=http://cjasn.asnjournals.org/cgi/pmidlookup?view=long&pmid=18667735 |accessdate=2011-12-15}}</ref><ref name="pmid18805152">{{cite journal |author=Benedetto U, Sciarretta S, Roscitano A, Fiorani B, Refice S, Angeloni E, Sinatra R |title=Preoperative Angiotensin-converting enzyme inhibitors and acute kidney injury after coronary artery bypass grafting |journal=[[The Annals of Thoracic Surgery]] |volume=86 |issue=4 |pages=1160–5 |year=2008 |month=October |pmid=18805152 |doi=10.1016/j.athoracsur.2008.06.018 |url=http://linkinghub.elsevier.com/retrieve/pii/S0003-4975(08)01321-0 |accessdate=2011-12-15}}</ref><ref name="pmid19822810">{{cite journal |author=Levin MA, Lin HM, Castillo JG, Adams DH, Reich DL, Fischer GW |title=Early on-cardiopulmonary bypass hypotension and other factors associated with vasoplegic syndrome |journal=[[Circulation]] |volume=120 |issue=17 |pages=1664–71 |year=2009 |month=October |pmid=19822810 |doi=10.1161/CIRCULATIONAHA.108.814533 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=19822810 |accessdate=2011-12-15}}</ref><ref name="pmid19682819">{{cite journal |author=Miceli A, Capoun R, Fino C, Narayan P, Bryan AJ, Angelini GD, Caputo M |title=Effects of angiotensin-converting enzyme inhibitor therapy on clinical outcome in patients undergoing coronary artery bypass grafting |journal=[[Journal of the American College of Cardiology]] |volume=54 |issue=19 |pages=1778–84 |year=2009 |month=November |pmid=19682819 |doi=10.1016/j.jacc.2009.07.008 |url=http://linkinghub.elsevier.com/retrieve/pii/S0735-1097(09)02359-6 |accessdate=2011-12-15}}</ref><ref name="pmid20691840">{{cite journal |author=Rader F, Van Wagoner DR, Gillinov AM, Blackstone EH |title=Preoperative angiotensin-blocking drug therapy is not associated with atrial fibrillation after cardiac surgery |journal=[[American Heart Journal]] |volume=160 |issue=2 |pages=329–336.e1 |year=2010 |month=August |pmid=20691840 |pmc=2919305 |doi=10.1016/j.ahj.2010.05.033 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-8703(10)00439-4 |accessdate=2011-12-15}}</ref><ref name="pmid17350856">{{cite journal |author=White CM, Kluger J, Lertsburapa K, Faheem O, Coleman CI |title=Effect of preoperative angiotensin converting enzyme inhibitor or angiotensin receptor blocker use on the frequency of atrial fibrillation after cardiac surgery: a cohort study from the atrial fibrillation suppression trials II and III |journal=[[European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery]] |volume=31 |issue=5 |pages=817–20 |year=2007 |month=May |pmid=17350856 |doi=10.1016/j.ejcts.2007.02.010 |url=http://linkinghub.elsevier.com/retrieve/pii/S1010-7940(07)00183-2 |accessdate=2011-12-15}}</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' The safety of initiating [[ACE inhibitors]] or [[ARBs|angiotensin-receptor blockers]] before hospital discharge is not well established.<ref name="pmid17307447">{{cite journal |author=Goyal A, Alexander JH, Hafley GE, Graham SH, Mehta RH, Mack MJ, Wolf RK, Cohn LH, Kouchoukos NT, Harrington RA, Gennevois D, Gibson CM, Califf RM, Ferguson TB, Peterson ED |title=Outcomes associated with the use of secondary prevention medications after coronary artery bypass graft surgery |journal=[[The Annals of Thoracic Surgery]] |volume=83 |issue=3 |pages=993–1001 |year=2007 |month=March |pmid=17307447 |doi=10.1016/j.athoracsur.2006.10.046 |url=http://linkinghub.elsevier.com/retrieve/pii/S0003-4975(06)02075-3 |accessdate=2011-12-15}}</ref><ref name="pmid17383303">{{cite journal |author=Fox KM, Bertrand ME, Remme WJ, Ferrari R, Simoons ML, Deckers JW |title=Efficacy of perindopril in reducing risk of cardiac events in patients with revascularized coronary artery disease |journal=[[American Heart Journal]] |volume=153 |issue=4 |pages=629–35 |year=2007 |month=April |pmid=17383303 |doi=10.1016/j.ahj.2007.01.032 |url=http://linkinghub.elsevier.com/retrieve/pii/S0002-8703(07)00091-9 |accessdate=2011-12-15}}</ref><ref name="pmid18071079">{{cite journal |author=Rouleau JL, Warnica WJ, Baillot R, Block PJ, Chocron S, Johnstone D, Myers MG, Calciu CD, Dalle-Ave S, Martineau P, Mormont C, van Gilst WH |title=Effects of angiotensin-converting enzyme inhibition in low-risk patients early after coronary artery bypass surgery |journal=[[Circulation]] |volume=117 |issue=1 |pages=24–31 |year=2008 |month=January |pmid=18071079 |doi=10.1161/CIRCULATIONAHA.106.685073 |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=18071079 |accessdate=2011-12-15}}</ref><ref name="pmid15466654">{{cite journal |author=Eagle KA, Guyton RA, Davidoff R, Edwards FH, Ewy GA, Gardner TJ, Hart JC, Herrmann HC, Hillis LD, Hutter AM, Lytle BW, Marlow RA, Nugent WC, Orszulak TA |title=ACC/AHA 2004 guideline update for coronary artery bypass graft surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1999 Guidelines for Coronary Artery Bypass Graft Surgery) |journal=[[Circulation]] |volume=110 |issue=14 |pages=e340–437 |year=2004 |month=October |pmid=15466654 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=15466654 |accessdate=2011-12-15}}</ref> ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}

==References==
{{reflist|2}}

{{WH}}
{{WS}}
[[Category:Cardiac surgery]]
[[Category:Cardiology]]
[[Category:Surgery]]