Why the study?
Whether stopping RAS inhibitors to minimise hypotension, or continuing them to avoid hypertension, reduces peri-operative myocardial injury remains unclear.
Does discontinuation of RAS inhibitors before non-cardiac surgery reduce peri-operative myocardial injury in patients aged ≥60 years?
Comparison
Discontinuation vs continuation of RAS inhibitors before surgery
Design
Multicentre randomized controlled trial with masked primary outcome assessment
Follow-up
48 h after surgery
Authors
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Either stopping or continuing RAS inhibitors perioperatively is acceptable; confirms neither strategy reduces myocardial injury in older non-cardiac surgery patients.
Does discontinuation of RAS inhibitors before non-cardiac surgery reduce peri-operative myocardial injury in patients aged ≥60 years?
Discontinuing RAS inhibitors before non-cardiac surgery did not reduce peri-operative myocardial injury and was associated with a higher risk of acute hypertension.
Ackland et al. (2023) studied this question.
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