Chest Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text Free
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Ripamonti, V.
Right arrow Articles by Ferratini, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Ripamonti, V.
Right arrow Articles by Ferratini, M.
(Chest. 2006;130:79-84.)
© 2006 American College of Chest Physicians

Angiotensin-Converting Enzyme Inhibitors Slow Recovery From Anemia Following Cardiac Surgery*

Vittorino Ripamonti, MD; Vittorio Racca, MD; Maria G. Calvo, MD; Paolo Castiglioni, PhD and Maurizio Ferratini, MD

* From the Unità Operativa Cardiologia Riabilitativa (Drs. Ripamonti, Racca, and Ferratini), Centro di Bioingegneria (Dr. Castiglioni) and Laboratorio analisi (Dr. Calvo), IRCCS S. Maria Nascente Fondazione Don C.Gnocchi, Milan, Italy.

Correspondence to: Vittorio Racca, MD, Istituto S. Maria Nascente Fondazione Don Carlo Gnocchi, Via Capecelatro 66, 20148 Milano, Italy; e-mail: cardiologia{at}dongnocchi.it

Abstract

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.

Key Words: anemia • angiotensin-converting enzyme inhibitors • cardiac rehabilitation • heart surgery






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 2006 by the American College of Chest Physicians.