Long term angiotensin converting enzyme-inhibition in patients after coronary artery bypass grafting reduces levels of soluble intercellular cell adhesion molecule-1

Objective: to examine the effect of angiotensin converting enzyme inhibition (ACEI) on soluble intercellular adhesion molecule 1 (sICAM-1) and C-reactive protein (CRP) in patients requiring coronary artery bypass grafting (CABG). Method: subgroup analysis of 42 patients randomised to Quinapril (40 mg daily determined) and 45 to placebo. sICAM-1 and CRP were greater than or equal to4 weeks before and 1 year after surgery. Results: there was no difference in sICAM-1 at baseline (142.2 mug/L vs 136.6 mug/L). There was significant reduction in sICAM-1 in patients receiving quinapril (142.2 +/- 10.8 mug/L vs 125.6 +/- 9.4 mug/L, p < 0.05) but not placebo (136.6 +/- 10.2 mug/L vs 131.2 +/- 11.7 mug/L, p = NS). Levels of C-reactive protein remained unchanged in both groups (3.70 +/- 0.85 vs 2.73 +/- 0.32 mg/L, 2.85 +/- 0.48 vs 3.16 +/- 0.50 mg/L). Conclusions: ACEI reduces sICAM-1 in patients undergoing CABG. The benefits of ACEI may partly be due to a reduction of the vascular inflammatory response.