Tehran University of Medical Sciences The Research in Heart Yield and Translational Medicine (RHYTHM) 3115-7270 8 4 2015 10 11 177 181 EN Ahmad Sharafi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Saeed Davoodi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. AbbasAli Karimi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Hosein Ahmadi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Kyomars Abbasi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Mahmood Sheikh-Fathollahi Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Payvand Bina Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Maryam Soleymanzadeh Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Arezoo Fehri Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Saeid Davaran Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Siroos Jahangheeri Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. Seyed Ebrahim Kassaian Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 11 2015 10 11 Background: There is controversy over the potential benefits/harms of the usage of angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) as regards the postoperative mortality of coronary artery bypass grafting (CABG). This study investigates the correlation between the in-hospital mortality of CABG and the preoperative administration of ACEI/ARB. Methods: Out of 10055 consecutive patients with isolated CABG from 2006 to 2009, 4664 (46.38%) patients received preoperative ACEI/ARB. Data were gathered from the Cardiac Surgery Registry of Tehran Heart Center. In-hospital mortality was defined as death within the same admission for surgery. Adjusted for confounders, multivariable logistic regression models were used to evaluate the impact of preoperative ACEI/ARB therapy on in-hospital death. Results: The mean age of the patients was 60.04 ± 9.51 years and 7364 (73.23%) were male. Eighty-seven (0.86%) patients expired within 30 days. Multivariate analysis revealed that the administration of ACEI/ARB significantly protected against in-hospital deaths inasmuch as there were 33 (0.70%) vs. 54 (1.0%) deaths in the ACEI/ARB positive and negative groups, respectively (OR: 0.628; p value = 0.09). Patients without ACEI/ARB were more likely to have a higher global ejection fraction. Conclusion: Preoperative ACEI usage in patients undergoing CABG can be associated with decreased in-hospital mortality. Large-scale randomized clinical trials are suggested. https://rhythm.tums.ac.ir/index.php/jthc/article/view/306 https://rhythm.tums.ac.ir/index.php/jthc/article/download/306/299