Effects of Antihypertensive Drugs on Outcomes of Breast Reconstruction.

Abstract:

BACKGROUND:Angiotensin receptor blocker (ARB), a commonly used antihypertensive drug, is reported to affect wound healing and flap survival in animal models. However, this has not been elucidated in a clinical series. This study aimed to investigate the impact that perioperative use of ARB has on outcomes after breast reconstruction. METHODS:Patients who underwent immediate breast reconstruction using a tissue expander or a deep inferior epigastric perforator (DIEP) flap were reviewed. The patients were categorized according to the types of antihypertensive medications as follows: the ARB group consisted of hypertensive patients treated with ARB alone or a combination of ARB and other drugs; the non-ARB group included those receiving drugs other than ARB; and the control group did not receive any medication. The effects of antihypertensive drugs on the development of complications were evaluated. RESULTS:The study analyzed 1390 cases including 999 cases of tissue-expander insertion and 391 cases of DIEP flap reconstruction. With regard to tissue-expander reconstruction, the rates of seroma, reoperation, reconstruction failure, and overall complications were significantly higher in the ARB group than in the other two groups. Compared with no medication, ARB use was an independent risk factor for these complications. With regard to DIEP flap reconstruction, the ARB group showed a significantly higher rate of fat necrosis and significantly greater odds for the development of overall perfusion-related complications and fat necrosis than the control group after adjustment for other variables. CONCLUSIONS:Perioperative administration of ARB might be associated with adverse outcomes after breast reconstruction.

journal_name

Ann Surg Oncol

authors

Park JW,Lee KT,Jeon BJ,Pyon JK,Bang SI,Mun GH

doi

10.1245/s10434-019-07293-z

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

1712-1719

issue

6

eissn

1068-9265

issn

1534-4681

pii

10.1245/s10434-019-07293-z

journal_volume

26

pub_type

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