Key result
Preoperative RASI therapy was not associated with a significant reduction in early all-cause mortality (OR 1.01; 95% CI 0.88-1.15; P=0.93), myocardial infarction, or stroke in cardiac surgery.
Why the study?
Does preoperative RASI therapy reduce major adverse cardiac events in patients undergoing cardiac surgery?
Population
54,528 cardiac surgery patients from 18 studies
Comparison
Preoperative renin-angiotensin system inhibitor… vs No preoperative RASI therapy
Design
Meta-analysis
Follow-up
early (perioperative)
Authors
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Does not support preoperative RASI for early MACE reduction in cardiac surgery; leaves open possible diabetic subgroup benefit for targeted trials.
Meta-Analysis (n=54,528)
Does preoperative RASI therapy reduce major adverse cardiac events in patients undergoing cardiac surgery?
Odds Ratio: 1.01 (95% CI 0.88–1.15)
p-value: p=0.93
Preoperative RASI therapy does not reduce early mortality or MACE in the general cardiac surgery population, though meta-regression suggests a potential mortality benefit in diabetic patients.
Cheng et al. (2014) conducted a meta-analysis in Cardiac surgery (n=54,528). Preoperative renin-angiotensin system inhibitor (RASI) therapy vs. Without preoperative RASI therapy was evaluated on Early all-cause mortality (OR 1.01, 95% CI 0.88-1.15, p=0.93). Preoperative RASI therapy was not associated with a significant reduction in early all-cause mortality (OR 1.01; 95% CI 0.88-1.15; P=0.93), myocardial infarction, or stroke in cardiac surgery.
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