Stopping versus continuing renin-angiotensin system inhibitors before surgery: An updated systematic review and meta-analysis of randomised controlled trials.

ABSTRACT:

Background and aims

The optimal perioperative management of patients chronically using renin-angiotensin system inhibitors (RASIs) is still uncertain. This study aims to compare the outcomes of withholding versus continuing RASIs before surgery, focusing on efficacy and safety.

Methods

A systematic review and meta-analysis synthesising evidence from randomised controlled trials (RCTs) obtained from PubMed, CENTRAL, Scopus, and Web of Science until September 2024. Using Stata MP v. 17, we used the fixed-effects model to report dichotomous outcomes by using the risk ratio (RR) with a 95% confidence interval (CI).

Results

Ten RCTs with 3,740 patients were included. There was no statistical difference between both groups regarding the incidence of major adverse cardiac ev

SUBMITTER: Algodi M 

PROVIDER: S-EPMC12445768 | biostudies-literature | 2025 Oct

REPOSITORIES: biostudies-literature