Coronary artery bypass surgery use of ACE Inhibitors/ARBs



==ACCF/AHA Guidelines for Perioperative use of ACE Inhibitors/ARBs == {{cquote|

Class I
1. ACE inhibitors and ARBs given before CABG should be reinstituted postoperatively once the patient is stable, unless contraindicated. (Level of Evidence: B)

2. ACE inhibitors or ARBs should be initiated postoperatively and continued indefinitely in CABG patients who were not receiving them preoperatively, who are stable, and who have an LVEF less than or equal to 40%, hypertension, diabetes mellitus, or CKD, unless contraindicated. (Level of Evidence: A)

Class IIa
1. It is reasonable to initiate ACE inhibitors or ARBs postoperatively and to continue them indefinitely in all CABG patients who were not receiving them preoperatively and are considered to be at low risk (ie, those with a normal LVEF in whom cardiovascular risk factors are well controlled), unless contraindicated. (Level of Evidence: B)

Class IIb
1. The safety of the preoperative administration of ACE inhibitors or ARBs in patients on chronic therapy is uncertain. (Level of Evidence: B)

2. The safety of initiating ACE inhibitors or ARBs before hospital discharge is not well established. (Level of Evidence: B)}}

Guidelines Resources

 * 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery : A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines