Background:
Post-procedural outcomes associated with the use of angiotensin converting enzyme inhibitors (ACEI) in patients undergoing percutaneous coronary intervention (PCI) have not been studied. We aimed to determine the association between ACEI use and adverse cardiovascular/ renal outcomes in these patients.
Methods:
We performed retrospective analysis of 15,485 consecutive patients who underwent percutaneous coronary intervention from January 1, 2000 to June 30, 2011. Primary outcome was the incidence of major adverse events (MAE) defined as a composite of mortality, post PCI renal dysfunction, myocardial infarction, and stroke during index hospitalization for PCI. Secondary outcome was the incidence of aforementioned components of MAE analyzed separately. Logistic regression and multivariate analyses were performed.
Results:
Of the patients undergoing PCI, 6,600 (43%) received pre-PCI ACEI and 8,885 (57%) did not. Patients on ACEI were more likely to be older (64.6 ± 10.9 years vs. 63.6 ± 12.1 years; p<0.0001), have diabetes (41% vs. 26%; p<0.0001), prior renal insufficiency (19% vs. 15%; p<0.0001) and ejection fraction less than 35% (9.6% vs. 7%; p<0.0001). There were no significant associations between pre-operative ACEI use and primary and secondary outcomes (table).
Conclusion:
Pre-operative ACEI use is not associated with major adverse events in patients undergoing PCI.
Key Words:
angiotensin converting enzyme inhibitor; percutaneous coronary intervention
Angiotensin-Converting Enzyme Inhibitor Prevents the Worsening of Renal Function in the Late Phase after Percutaneous Coronary Intervention