Document Detail

Angiotensin-converting enzyme inhibitors slow recovery from anemia following cardiac surgery.
MedLine Citation:
PMID:  16840386     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: Angiotensin-converting enzyme (ACE) inhibitors, which are frequently administered in patients with heart disease, have a known inhibitory effect on erythropoiesis. The aim of this study was to detect whether early ACE inhibitor administration slows recovery from anemia following recent cardiac surgery. METHODS AND RESULTS: Forty male patients with anemia (hemoglobin < 12 g/dL) an average of 9 days after cardiac surgery were randomized to receive enalapril (ACE inhibitor group) or not. All of the patients received ferrous sulfate, 525 mg, in addition to standard therapy. Patients with anemia due to other causes were excluded. Blood samples were obtained at baseline, and after 8 days, 16 days, and 60 days. A 6-min walking test and echocardioscan were performed at baseline, and after 16 days and 60 days of treatment, and a chest radiograph was obtained at baseline and after 60 days. The ACE inhibitor group showed a statistically significant lower increase in hemoglobin and RBC values. The peak between-group differences of 1 g/dL of hemoglobin (p = 0.012) and 444 RBCs per milliliter (p = 0.017) were observed on day 16. CONCLUSIONS: Early enalapril maleate administration in anemic patients after heart surgery significantly inhibits erythropoiesis. This unfavorable effect on anemia should be considered when prescribing ACE inhibitors for such patients.
Vittorino Ripamonti; Vittorio Racca; Maria G Calvo; Paolo Castiglioni; Maurizio Ferratini
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Chest     Volume:  130     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  2006 Jul 
Date Detail:
Created Date:  2006-07-14     Completed Date:  2006-08-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-84     Citation Subset:  AIM; IM    
Unità Operativa Cardiologia Rehabilitativa, IRCCS S. Maria Nascente Fondazione Don C. Gnocchi, Milan, Italy.
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MeSH Terms
Anemia / drug therapy
Angiotensin-Converting Enzyme Inhibitors / adverse effects*,  therapeutic use
Cardiac Surgical Procedures
Enalapril / adverse effects*,  therapeutic use
Erythropoiesis / drug effects*
Hemoglobins / drug effects*
Middle Aged
Postoperative Period
Stroke Volume / drug effects
Reg. No./Substance:
0/Angiotensin-Converting Enzyme Inhibitors; 0/Hemoglobins; 75847-73-3/Enalapril

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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