Özgür Barış TOPÇU, Muhip KANKO, Hakan PARLAR, Şadan YAVUZ, Kamil Turan BERKİ

The Effectof Angiotensin Converting Enzyme Inhibitor Therapy on Mortality and Morbidity in Patients Undergoing Coronary Artery Bypass Grafting Surgery

INTRODUCTION: The aim of this study was to evaluate the effects of angiotensin-converting enzyme inhibitor (ACEI) therapy on mortality and morbidity in patients undergoing coronary artery bypass grafting (CABG) operation. METHODS:Hospital records of patients undergoing CABG surgery were evaluated retrospectively. Demographic characteristics, comorbidities, functional classification and post-operative complications of patients were recorded. RESULTS: 42 women and 101 men, totally 143 patients were included in the study. There were 65 cases, mean aged 59.8 ± 8.86 years in non-user group and 78 cases, mean aged 58.15 ± 8.59 years in ACEI user group. When pre-operative specialties of groups were evaluated; there were no statistically significant difference of diabetes mellitus (DM), hyperlipidemia, smoking habits, pre-operative and recent MI, chronic obstructive pulmonary disease (COPD) and NYHA classification between groups (p>0.05). Hypertension and unstable angina pectoris (USAP) frequency were statistically significantly high in ACEI group (p>0.05). There was no statistically significant difference of post-operative complications and mortality between groups (p>0.05), but post-operative major events were higher in ACEI groups than non-users (p=0.007). Duration of stay in intensive care unit (ICU) was long in 50% of patients in ACEI group. There was a statistically significant difference for duration of ICU among groups (p=0.012). DISCUSSION AND CONCLUSION: Pre-operative therapy with ACEI is associated with a prolonged stay in ICU even though there is no statistically significant difference of mortality and morbidity between ACEI user and non-user groups.

Anjiotensin Dönüştürücü Enzim İnhibitörlerinin Koroner Arter Baypas Cerrahisi Yapılan Hastalarda Mortalite ve Morbidite Üzerine Etkisi

GİRİŞ ve AMAÇ: Bu çalışmanın amacı, koroner arter baypas greftleme (KABG) operasyonu geçiren hastalarda anjiyotensin dönüştürücü enzim inhibitörü (ADEI) tedavisinin mortalite ve morbidite üzerindeki etkilerini değerlendirmektir. YÖNTEM ve GEREÇLER: KABG ameliyatı geçiren hastaların hastane kayıtları geriye dönük olarak değerlendirildi. Hastaların demografik özellikleri, komorbiditeleri, fonksiyonel sınıflaması ve postoperatif komplikasyonları kaydedildi. BULGULAR: Çalışmaya 42'si kadın 101'i erkek toplam 143 hasta dahil edildi. ADEİ kullanmayan 65 kişide ortalama yaş 59.8 ± 8.86 yıl, ADEİ kullanan 78 kişide ise 58.15 ± 8.59 yıl idi. Grupların ameliyat öncesi özellikleri değerlendirildiğinde; diabetes mellitus, hiperlipidemi, sigara içme alışkanlıkları, yakınmiyokard enfarktüsü, kronik obstrüktif akciğer hastalığı ve New York Heart Association fonksiyonel kapasite sınıflaması açısından gruplar arasında istatistiksel olarak anlamlı fark yoktu (p> 0.05). ADEİ grubunda hipertansiyon ve anstabil angina pektoris sıklığı, istatistiksel olarak anlamlı yüksek bulundu (p> 0.05). Gruplar arasında postoperatif komplikasyonlar ve mortalite açısından istatistiksel olarak anlamlı bir fark yoktu (p> 0.05); zira postoperatif majör olaylar ADEİ kullanan grupta kullanmayanlara göre daha yüksekti (p = 0.007). ADEİ kullanan hastaların%50'sinde yoğun bakım ünitesinde kalış süresi uzundu. Gruplar arasında yoğun bakım ünitesinde kalış süresi açısından istatistiksel olarak anlamlı fark vardı (p = 0,012). TARTIŞMA ve SONUÇ: ADEİ kullanan ve kullanmayan gruplar arasında istatistiksel olarak anlamlı bir mortalite ve morbidite farkı olmamasına rağmen, preoperatif ADEİ kullanımı, KABG operasyonu yapılan hastalarda yoğun bakım ünitesinde uzun süreli kalışla ilişkilidir.

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