Angiotensin-converting enzyme inhibitor or angiotensin receptor blocker use is associated with reduced major adverse cardiovascular events among patients with critical limb ischemia

• Published in: Vascular medicine (London, England) England), 2015-06, Vol.20 (3), p.237-244
• Main Authors: Armstrong, Ehrin J, Chen, Debbie C, Singh, Gagan D, Amsterdam, Ezra A, Laird, John R
• Format: Article
• Language: English
• Subjects: Aged; Angiotensin Receptor Antagonists - therapeutic use; Angiotensin-Converting Enzyme Inhibitors - therapeutic use; Cardiovascular Diseases - etiology; Cardiovascular Diseases - prevention & control; Critical Illness; Female; Follow-Up Studies; Humans; Ischemia - complications; Leg - blood supply; Male; Proto-Oncogene Proteins; Receptors, G-Protein-Coupled; Retrospective Studies; Time Factors
• ISSN: 1358-863X; 1477-0377
• DOI: 10.1177/1358863X15574321

Angiotensin converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) are recommended for secondary prevention in peripheral artery disease, but their effectiveness in patients with critical limb ischemia (CLI) is uncertain. We reviewed 464 patients with CLI who underwent diagnostic angiography or endovascular intervention from 2006–2013 at a multidisciplinary vascular center. ACEI or ARB use was assessed at the time of angiography. Major adverse cardiovascular events (MACE), mortality, and major adverse limb events (MALE) were assessed during three-year follow-up. Propensity weighting was used to adjust for baseline differences between patients taking and not taking ACEIs or ARBs. ACEIs or ARBs were prescribed to 269 (58%) patients. Patients prescribed ACEIs or ARBs had more baseline comorbidities including diabetes and hypertension (p