Why the study?
Does continuing ACE-I/ARBs before noncardiac surgery affect mortality or MACE compared to withholding them?
Does continuing ACE-I/ARBs before noncardiac surgery affect mortality or MACE compared to withholding them?
Perioperative continuation of ACE-I/ARBs before noncardiac surgery is associated with increased intraoperative hypotension but no difference in mortality or MACE.
Suggests withholding ACE-I/ARBs preoperatively to reduce hypotension risk; confirms no mortality or MACE difference.
This meta-analysis did not demonstrate an association between perioperative administration of ACE-I/ARB and mortality or MACE. It did, however, confirm the current observation that perioperative continuation of ACE-I/ARBs is associated with an increased incidence of intraoperative hypotension. A large randomized control trial is necessary to determine the appropriate perioperative management of ACE-I and ARBs.
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Hollmann et al. (2018) studied this question.
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