Impact of angiotensin converting enzyme inhibition on post- coronary artery bypass interleukin 6 release

Brull, D.J., Sanders, J., Rumley, A., Lowe, G.D., Humphries, S.E. and Montgomery, H.E. (2002) Impact of angiotensin converting enzyme inhibition on post- coronary artery bypass interleukin 6 release. Heart, 87(3), pp. 252-255.

Abstract

Background: Angiotensin 1 converting enzyme (ACE) inhibitors reduce morbidity and mortality after coronary artery bypass graft surgery (CABG). This benefit may result from an anti- inflammatory action. Objective: To examine the effect of ACE inhibition on interleukin 6 (IL-6) concentrations after CABG. Patients and methods: 16 1 patients undergoing elective first time CABG were recruited, of whom 41 (25%) were receiving ACE inhibitor treatment; 2 1 patients with confounding postoperative complications were excluded. After these exclusions there were 33 patients (24%) on ACE inhibitor treatment. Plasma IL-6 was measured preoperatively and again six hours after CABG. Results: Baseline IL-6 concentrations (geometric mean (SEM)) were non-significantly lower among the patients receiving ACE inhibitors (3.7 (0.1) v 4.3 (0, 1) pg/ml, p = 0.12). Overall, post-CABG IL-6 concentrations increased significantly (mean rise 177 (12) pg/ml, p lt 0.0005). This response was blunted among ACE inhibitor treated patients. Median increases in IL-6 concentrations were 117 v 193 pg/ml, for treated v non-treated patients, respectively (Kruskol- Wallis, p = 0.02), with peak postoperative IL-6 concentrations lower among the subjects receiving ACE inhibitors than in untreated subjects (142 (19) v 196 (13) pg/ml, p = 0.02). The effect of ACE inhibitors remained significant after multivariate analysis (p = 0.018). Conclusions: ACE inhibitor treatment is associated with a reduction in IL-6 response to CABG. The data suggest that this class of drug may have a direct anti-inflammatory effect, which could explain some of its clinical benefit.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Rumley, Dr Ann and Lowe, Professor Gordon
• Authors: Brull, D.J., Sanders, J., Rumley, A., Lowe, G.D., Humphries, S.E., and Montgomery, H.E.
• Subjects: R Medicine > RC Internal medicine; Q Science > QM Human anatomy
• College/School: College of Medical Veterinary and Life Sciences
• Journal Name: Heart
• Publisher: BMJ Publishing Group
• ISSN: 1355-6037
• Copyright Holders: © BMJ Publishing Group
• First Published: First published in Heart 87(3):252-255
• Publisher Policy: Reproduced in accordance with the copyright policy of the publisher