Perioperative medicine & outcomes
Continuation versus discontinuation of renin-angiotensin aldosterone system inhibitors before non-cardiac surgery: A systematic review and meta-analysis
An erratum to this article was published (J Clin Anesth, Jan 2025 ↗)
Pooled result · MortalityResult — go to the resultOdds ratio 1.10 95 % CI 0.86–1.40Authors' conclusion
Withholding RAAS inhibitors before noncardiac surgery reduces intraoperative hypotension and AKI with nonsignificant effects on mortality and MACE.
Study context
- Population
- Patients on RAAS inhibitors (angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs)) before noncardiac surgery
- Participants
- 59,105 patients · 16 studies
- Comparison
- Withholding vs continuing RAAS inhibitors before noncardiac surgery
- Outcome
- Perioperative mortality and complications
Methodological detailsrandom-effects model, PubMed/MEDLINE, Embase and Cochrane Library searched to August 30, 2024
- Random-effects model
- PubMed/MEDLINE, Embase and Cochrane Library searched to August 30, 2024
Pooled result
Mortality
Odds ratio
1.10
95 % CI 0.86–1.40
Withholding vs Continuing
OR 1.10 (95 % CI 0.86–1.40)
As reported in the abstract
Further pooled results
| Outcome | OR (95 % CI) | |
|---|---|---|
| Intraoperative hypotensionSignificantly lower incidence | 0.49 (0.29–0.83) | |
| AKISignificantly lower incidence | 0.88 (0.82–0.95) | |
| MACE | 1.27 (0.75–2.16) | |
| MI | 0.83 (0.27–2.59) | |
| Stroke | 0.70 (0.36–1.36) | |
| 0.20.5125Odds ratio (log scale) |
Original publication
Continuation versus discontinuation of renin-angiotensin aldosterone system inhibitors before non-cardiac surgery: A systematic review and meta-analysis. J Clin Anesth. Published 11 November 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →