Hold ACE inhibitors and ARBs before noncardiac surgery? Emerging evidence suggests a patient-specific approach.
review · Level V
Where this comes from
- Record sourced from PubMed, PMID 41033844.
- Also identified by DOI 10.3949/ccjm.92a.25035.
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Abstract
Although withholding these drugs before noncardiac surgery reduces the risk of intraoperative hypotension, recent trials suggest that it leads to harm in sicker patients. An individualized approach is safest, particularly in patients with heart failure. This review examines the emerging evidence regarding the impact of pausing vs continuing these drugs on intraoperative hypotension, myocardial injury, acute kidney injury, and postoperative outcomes.
Medical subject headings
- Angiotensin-Converting Enzyme Inhibitors
- Angiotensin Receptor Antagonists
- Surgical Procedures, Operative
- Preoperative Care
- Intraoperative Complications