The renin angiotensin system in bypass graft surgery

The renin angiotensin system is implicated in the development of vein graft disease after coronary artery bypass surgery. Components of this system ha ve been shown to play important roles in determining the short-term and lon g-term performance of coronary artery bypass grafts, Significant difference s exist in the commonly used arterial and venous grafts in angiotensin conv erting enzyme activity and angiotensin responses. The existence of a dual e nzyme pathway in angiotensin II formation has also been demonstrated. Such findings have implications for the use of AT(1)-receptor antagonists over e nzyme inhibitors to improve graft performance and prevent the development o f coronary artery bypass graft disease. (C) 2000 Lippincott Williams & Wilk ins, Inc.