Table 4.
Influence of chronic kidney disease, congestive heart failure, and diabetes on association between preoperative ACEi/ARB use and outcomes
| Outcomes | Presence/absence of comorbid condition | Adjusted a RR (95% CI) | P value (test for interaction) | |
|---|---|---|---|---|
| AKI-D |
CKD |
Yes |
0.62 (0.50, 0.78) |
< 0.001 |
| |
No |
1.00 (0.81, 1.24) |
||
| |
CHF |
Yes |
0.62 (0.45, 0.85) |
0.29 |
| |
|
No |
0.81 (0.65, 1.00) |
|
| |
Diabetes |
Yes |
0.63 (0.43, 0.91) |
0.56 |
| |
|
No |
0.77 (0.63, 0.94) |
|
| All-cause mortality |
CKD |
Yes |
0.86 (0.75, 0.98) |
0.26 |
| |
No |
0.91 (0.87, 0.96) |
||
| |
CHF |
Yes |
1.01 (0.91, 1.12) |
0.06 |
| |
|
No |
0.92 (0.86, 0.97) |
|
| |
Diabetes |
Yes |
0.96 (0.86, 1.09) |
0.34 |
| No | 0.93 (0.88, 0.99) | |||
ACEi: Angiotensin converting enzyme inhibitor; ARB: Angiotensin receptor blocker; RR: Relative risk; CI: Confidence interval; AKI-D: Acute kidney injury treated with dialysis; CKD: Chronic kidney disease; CHF: Congestive heart failure.
Outcomes: (1) Primary outcome: AKI-D (within 14 days after surgery); (2) Secondary outcome: All-cause mortality (within 90 days after surgery).
Relative risk was calculated for preoperative ACEi or ARB use compared to non-use.
aCKD sub-group analyses: adjusted for age, sex, coronary artery disease, congestive heart failure, cerebrovascular disease, peripheral vascular disease, chronic obstructive pulmonary disease, chronic liver disease, anti-diabetic agents, beta-adrenergic blockers, calcium channel blockers, non-potassium sparing diuretics, statins, type of surgery (cardiac, vascular, thoracic, abdominal, retro-peritoneal), era of surgery (1995 to 1998, 1999 to 2001, 2002 to 2004, 2005 to 2007, 2008 to 2010).
aCHF sub-group analyses: adjusted for age, sex, coronary artery disease, chronic kidney disease, cerebrovascular disease, peripheral vascular disease, chronic obstructive pulmonary disease, chronic liver disease, anti-diabetic agents, beta-adrenergic blockers, calcium channel blockers, non-potassium sparing diuretics, statins, type of surgery (cardiac, vascular, thoracic, abdominal, retro-peritoneal), era of surgery (1995 to 1998, 1999 to 2001, 2002 to 2004, 2005 to 2007, 2008 to 2010).
aDiabetes sub-group analyses: adjusted for age, sex, coronary artery disease, chronic kidney disease, congestive heart failure, cerebrovascular disease, peripheral vascular disease, chronic obstructive pulmonary disease, chronic liver disease, beta-adrenergic blockers, calcium channel blockers, non-potassium sparing diuretics, statins, type of surgery (cardiac, vascular, thoracic, abdominal, retro-peritoneal), era of surgery (1995 to 1998, 1999 to 2001, 2002 to 2004, 2005 to 2007, 2008 to 2010).