title: Effect of angiotensin converting enzyme inhibitors on periprocedural myocardial infarction in patients with metabolic syndrome.
abstract: BACKGROUND
  Metabolic syndrome (MetS) has been reported as a risk factor for cardiovascular events. The aim of the present study is to investigate the association between chronic angiotensin-converting enzyme inhibitors (ACE-I) therapy and the rate of periprocedural myocardial infarction (PMI) after elective coronary stenting among patients with MetS.
  
  
  METHODS
  The inclusion criteria were MetS and plan for elective percutaneous coronary intervention. To assess the effect of ACE-I treatment on the incidence of PMI, measurements of cardiac biomarkers (CK-MB mass and troponin I) were performed at baseline and 24 h after the procedure.
  
  
  RESULTS
  A total of 459 patients fulfilling the inclusion criteria were recruited to chronic ACE-I treatment and ACE-I naive groups in a 2/1 ratio. Baseline troponin I and CK-MB levels were similar in both treatment groups, whereas they were significantly lower in ACE-I group 24 h after the procedure. Univariate analysis identified body mass index (BMI), LDL cholesterol, nitrate and ACE-I use as significant factors for the development of PMI. Multivariate regression model revealed that body mass index increased and use of nitrate and ACE-I decreased the probability of PMI independent from confounding factors (OR 1.14, 95% CI 1.05-1.23, p = 0.002 for BMI; OR 0.26, 95% CI 0.14-0.48, p = 0.01 for nitrate use, OR 0.51, 95% CI 0.27-0.93, p = 0.03 for ACE-I use).
  
  
  CONCLUSIONS
  This prospective observational cohort trial demonstrated that chronic ACE-I therapy was an independent predictor for reduced PMI among patients with MetS who underwent elective coronary intervention.
authors.forename: Ozgur Ulas
authors.initials: OU
authors.lastname: Ozcan
authors.forename: Elif Ezgi
authors.initials: EE
authors.lastname: Ustun
authors.forename: Sadi
authors.initials: S
authors.lastname: Gulec
authors.forename: Demet Menekse
authors.initials: DM
authors.lastname: Gerede
authors.forename: Huseyin
authors.initials: H
authors.lastname: Goksuluk
authors.forename: Veysel Kutay
authors.initials: VK
authors.lastname: Vurgun
authors.forename: Cansin Tulunay
authors.initials: CT
authors.lastname: Kaya
authors.forename: Cetin
authors.initials: C
authors.lastname: Erol
mesh_terms: D000368:Aged; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D052279:Creatine Kinase, MB Form / Q000097:blood; D005260:Female; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D016017:Odds Ratio; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome; D019210:Troponin I / Q000097:blood; D014421:Turkey / Q000453:epidemiology
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D015415:Biomarkers; D019210:Troponin I; D052279:Creatine Kinase, MB Form